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General NPI Number Information
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NPI Number | 1508631763
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Entity Type | Organization
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Legal Business Name | FOLLOWERS OF THE WAY
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 5480 GREENE 707 ROAD
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City | PARAGOULD
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State | AR
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Zip | 72450
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Country | US
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Telephone | 870-253-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 PARAGOULD PLAZA PMB 114
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City | PARAGOULD
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State | AR
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Zip | 72450
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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 | DIRECTOR
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Name | JAMIE MANN
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Credential |
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Telephone | 870-819-2396
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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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