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NPI 1104246628

NPI 1104246628 : RESOLUTIONS HEATLH ALLIANCE : LAKE CITY, FL

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General NPI Number Information
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    NPI Number           |    1104246628
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    Entity Type          |    Organization 
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    Legal Business Name  |    RESOLUTIONS HEATLH ALLIANCE 
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Dates
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    Enumeration Date     |    04/23/2014
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    Last Update Date     |    07/27/2021
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Provider Practice Location Address
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    Address Line         |    492 W DUVAL ST 
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    City                 |    LAKE CITY
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    State                |    FL
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    Zip                  |    32055-3899
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    Country              |    US
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    Telephone            |    386-754-9005
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    Fax                  |    386-754-9011
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Provider Business Mailing Address
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    Address Line         |    492 W DUVAL ST 
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    City                 |    LAKE CITY
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    State                |    FL
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    Zip                  |    32055-3899
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    Country              |    US
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    Telephone            |    386-754-9005
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    Fax                  |    386-754-9011
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     ERIN  CRUMITIE 
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    Credential           |    
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    Telephone            |    386-754-9005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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