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General NPI Number Information
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NPI Number | 1699088179
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Entity Type | Organization
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Legal Business Name | ARIADYNE HEALTH
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 46 SANDLEWOOD DR
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City | BRANDON
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State | MS
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Zip | 39042-2323
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Country | US
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Telephone | 601-672-3611
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2145
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City | BRANDON
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State | MS
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Zip | 39043-2145
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Country | US
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Telephone | 601-672-3611
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT W SIMS
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Credential |
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Telephone | 601-672-3611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C7458
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License Number State | AL
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