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General NPI Number Information
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NPI Number | 1447507165
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Entity Type | Organization
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Legal Business Name | TATE COUNSELING SERVICES
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 1006 MARS HILL RD
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City | FLORENCE
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State | AL
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Zip | 35630-1048
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Country | US
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Telephone | 256-335-7132
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 MARS HILL RD
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City | FLORENCE
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State | AL
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Zip | 35630-1048
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Country | US
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Telephone | 256-335-7132
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | MR. MARK DANIEL TATE
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Credential | L.P.C.
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Telephone | 256-335-7132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 3062
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License Number State | AL
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