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General NPI Number Information
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NPI Number | 1467041996
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Entity Type | Organization
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Legal Business Name | AFFIRMING CARE COUNSELING AND WELLNESS LLC
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Dates
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Enumeration Date | 01/11/2021
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 7806 VAUGHN RD
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City | MONTGOMERY
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State | AL
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Zip | 36116-1333
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Country | US
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Telephone | 334-413-4055
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Fax |
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Provider Business Mailing Address
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Address Line | 464 BLACK RAVENS CT
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-6455
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Country | US
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Telephone | 706-442-5372
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | KIMYATTA GREATHOUSE FAILS
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Credential |
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Telephone | 334-413-4055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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