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General NPI Number Information
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NPI Number | 1457654568
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Entity Type | Organization
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Legal Business Name | ORIGEN BETTER.LLC
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 1200 S UNION AVE NONE
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City | ALLIANCE
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State | OH
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Zip | 44601-4021
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Country | US
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Telephone | 330-000-0001
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Fax | 330-000-0003
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Provider Business Mailing Address
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Address Line | 1200 S UNION AVE NONE
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City | ALLIANCE
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State | OH
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Zip | 44601-4021
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Country | US
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Telephone | 330-000-0001
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Fax | 330-000-0003
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Authorized Official
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Title or Position | CHAPLAIN
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Name | MS. TRALADA W PURNELL
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Credential | MINISTER
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Telephone | 330-000-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 305R00000X
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License Number State | OH
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