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General NPI Number Information
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NPI Number | 1649699091
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Entity Type | Organization
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Legal Business Name | DIRECTIONS
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 256 COUNTY ROAD 45
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City | THOMASVILLE
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State | AL
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Zip | 36784-3725
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Country | US
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Telephone | 334-992-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 FAIR MEADOW LN
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City | PIKE ROAD
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State | AL
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Zip | 36064-2603
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Country | US
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Telephone | 334-202-2825
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CHRISTOPHER NARCISSE
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Credential |
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Telephone | 334-202-2825
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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