Healthcare Provider Details

I. General information

NPI: 1629812664
Provider Name (Legal Business Name): SILVER LINING RESCUE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 W RAILROAD AVE
BOSTON GA
31626-2674
US

IV. Provider business mailing address

PO BOX 195
BOSTON GA
31626-0195
US

V. Phone/Fax

Practice location:
  • Phone: 229-289-2252
  • Fax:
Mailing address:
  • Phone: 229-289-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: STARKISHA NICOLE BELLE
Title or Position: OWNER
Credential: CADCII, CCS,MATS
Phone: 229-289-2252