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General NPI Number Information
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NPI Number | 1578173464
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Entity Type | Organization
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Legal Business Name | H3O LIVING, LLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 29000 U.S. 98
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City | DAPHNE
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State | AL
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Zip | 36526
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Country | US
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Telephone | 251-626-5797
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 N ALSTON ST
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City | FOLEY
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State | AL
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Zip | 36535-3513
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Country | US
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Telephone | 309-242-7750
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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 | JOSEPH R FRITCHLEY
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Credential | MDIV, LCSW
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Telephone | 309-242-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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