Healthcare Provider Details

I. General information

NPI: 1336619246
Provider Name (Legal Business Name): SAVING LOST SOULS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BROADWAY ST STE 1313
TOLEDO OH
43609-2809
US

IV. Provider business mailing address

1301 BROADWAY ST
TOLEDO OH
43609-2809
US

V. Phone/Fax

Practice location:
  • Phone: 419-509-3242
  • Fax:
Mailing address:
  • Phone: 419-509-3242
  • 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 Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name: MR. ARTHUR C BUCHANAN
Title or Position: OWNER
Credential:
Phone: 419-509-3242