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General NPI Number Information
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NPI Number | 1952017188
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Entity Type | Organization
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Legal Business Name | REAL LIFE SOLUTIONS BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 18848 STATE ROUTE 136
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City | WINCHESTER
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State | OH
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Zip | 45697
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Country | US
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Telephone | 937-417-8049
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Fax | 937-504-5106
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Provider Business Mailing Address
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Address Line | 10493 RUSSELLVILLLE-WINCHESTER RD
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City | WINCHESTER
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State | OH
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Zip | 45697-9638
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Country | US
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Telephone | 937-205-6667
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Fax | 937-504-5106
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Authorized Official
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Title or Position | CEO
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Name | MARCIA L SILCOTT
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Credential | CNP
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Telephone | 937-205-6667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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