Healthcare Provider Details

I. General information

NPI: 1154924967
Provider Name (Legal Business Name): ZEN FOR LIFE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 W ASHFORD PARK DR
FOLEY AL
36535-1148
US

IV. Provider business mailing address

2474 W ASHFORD PARK DR
FOLEY AL
36535-1148
US

V. Phone/Fax

Practice location:
  • Phone: 870-341-3191
  • Fax:
Mailing address:
  • Phone: 870-341-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. NIVA W BROWN
Title or Position: COUNSELOR
Credential: LPC, NCC, CRC
Phone: 870-341-3191