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General NPI Number Information
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NPI Number | 1891902607
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Entity Type | Organization
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Legal Business Name | EMOTIONAL RECOVERY AND WELLNESS CENTER, INC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 25 W GUILFORD ST SUITE 7
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City | THOMASVILLE
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State | NC
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Zip | 27360-3945
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Country | US
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Telephone | 336-474-7530
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Fax | 336-474-7531
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Provider Business Mailing Address
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Address Line | 25 W GUILFORD ST SUITE 7
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City | THOMASVILLE
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State | NC
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Zip | 27360-3945
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Country | US
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Telephone | 336-474-7530
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Fax | 336-474-7531
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL M HERIN
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Credential | LCSW
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Telephone | 336-474-7530
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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 | COO2426
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License Number State | NC
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