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General NPI Number Information
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NPI Number | 1578894184
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Entity Type | Organization
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Legal Business Name | ADAMS PLACE FOR WELLNESS LLC
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 848 E FRANKLIN ST STE D4
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City | CENTERVILLE
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State | OH
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Zip | 45459-5693
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Country | US
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Telephone | 937-439-2955
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Fax | 937-439-2970
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Provider Business Mailing Address
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Address Line | 848D E. FRANKLIN STR #4
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City | CENTERVILLE
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State | OH
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Zip | 45459
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Country | US
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Telephone | 937-439-2955
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Fax | 937-439-2970
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Authorized Official
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Title or Position | SOLE PROPRIETOR/THERAPIST
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Name | MRS. ROBIN ADAMS
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Credential | LISW
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Telephone | 937-439-2955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I-8178
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License Number State | OH
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