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General NPI Number Information
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NPI Number | 1992576656
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Entity Type | Organization
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Legal Business Name | ART AND HEALING WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 880 RIDGEWOOD ST STE 4
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8466
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Country | US
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Telephone | 210-675-0066
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Fax | 210-675-0066
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Provider Business Mailing Address
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Address Line | 1314 W SAINT CHARLES ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6504
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Country | US
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Telephone | 956-639-7172
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Fax |
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Authorized Official
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Title or Position | OFFICE AND BILLING MANAGER
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Name | MR. DANIEL VIDAURRI
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Credential |
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Telephone | 210-675-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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