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General NPI Number Information
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NPI Number | 1255921383
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Entity Type | Organization
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Legal Business Name | FAITH-FAMILY ADDICTION INTERVENTION THROUGH HEALING
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 2 MAPLE TER
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City | PEABODY
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State | MA
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Zip | 01960-6233
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Country | US
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Telephone | 978-460-4029
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MAPLE TER
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City | PEABODY
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State | MA
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Zip | 01960-6233
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENISE GARABEDIAN
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Credential |
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Telephone | 978-430-4029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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