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General NPI Number Information
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NPI Number | 1184438673
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Entity Type | Organization
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Legal Business Name | SANAMENTE ALIADOS
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1121 JUDSON RD STE 140
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City | LONGVIEW
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State | TX
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Zip | 75601-5119
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Country | US
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Telephone | 903-309-0702
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Fax |
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Provider Business Mailing Address
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Address Line | 806 JACK CT
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City | LONGVIEW
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State | TX
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Zip | 75601-8716
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Country | US
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Telephone | 805-512-2401
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY PEREZ
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Credential | LCSW
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Telephone | 903-309-0702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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