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NPI Code Detail

MEDICARE: PURA VIDA COUNSELING SERVICES PLLC

MEDICARE: PURA VIDA COUNSELING SERVICES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1215244165
Entity Type Code : Organization
Provider Name (Legal Business Name) : PURA VIDA COUNSELING SERVICES PLLC
Provider Business Mailing Address
First Line : 918 WEST NOLANA LOOP
Second Line :
City : PHARR
State : TX
Zip : 78577
Country : US
Telephone Number : 956-227-5239
Fax Number :
Provider Business Practice Location Address
First Line : 918 WEST NOLANA LOOP
Second Line :
City : PHARR
State : TX
Zip : 78577-8340
Country : US
Telephone Number : 956-227-5239
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. ANDREA LEIGH LACY
Credential :
Telephone Number : 956-227-5239
Provider Enumeration Date : 09/13/2010
Last Update Date : 09/13/2010

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Directions to “PURA VIDA COUNSELING SERVICES PLLC ” Practice Location

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