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General NPI Number Information
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NPI Number | 1598229106
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Entity Type | Organization
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Legal Business Name | ENLIVEN HEALTH AND WELLNESS
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 4207 GARDENDALE ST STE B103
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3182
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Country | US
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Telephone | 210-999-5579
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Fax |
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Provider Business Mailing Address
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Address Line | 4207 GARDENDALE ST STE B013
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3182
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Country | US
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Telephone | 210-999-5579
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST/OWNER
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Name | BETHANY RICHARDSON
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Credential | LAC
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Telephone | 510-388-6077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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