Healthcare Provider Details

I. General information

NPI: 1033533831
Provider Name (Legal Business Name): ADULT CHILD AND FAMILY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14138 HWY 195
KILLEEN TX
76542-4850
US

IV. Provider business mailing address

14138 HWY 195
KILLEEN TX
76542-4850
US

V. Phone/Fax

Practice location:
  • Phone: 254-519-1144
  • Fax: 254-519-1155
Mailing address:
  • Phone: 254-519-1144
  • Fax: 254-519-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number69513
License Number StateTX

VIII. Authorized Official

Name: AMY-JO NEUJAHR
Title or Position: BILLING/CARE DETAILING
Credential:
Phone: 254-690-2707