MEDICARE: TOTAL LIFE CLINICIANS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1508890351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL LIFE CLINICIANS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 129
Second Line	:
City	:	BUCKHANNON
State	:	WV
Zip	:	26201-0129
Country	:	US
Telephone Number	:	304-473-8988
Fax Number	:	304-472-9849

Provider Business Practice Location Address
First Line	:	RT 4 & 20 SOUTH
Second Line	:	2ND FLOOR
City	:	ROCK CAVE
State	:	WV
Zip	:	26234
Country	:	US
Telephone Number	:	304-473-8988
Fax Number	:	304-472-9849

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREENBRIER DAVID RALPH ALMOND
Credential	:	M.D.
Telephone Number	:	304-473-8988

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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