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NPI Code Detail

MEDICARE: PEAK PERFORMANCE COUNSELING AND CONSULTING LLC

MEDICARE: PEAK PERFORMANCE COUNSELING AND CONSULTING 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1801520812
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEAK PERFORMANCE COUNSELING AND CONSULTING LLC
Provider Business Mailing Address
First Line : 505 E 9TH ST
Second Line :
City : GROVE
State : OK
Zip : 74344-2934
Country : US
Telephone Number : 620-515-1080
Fax Number :
Provider Business Practice Location Address
First Line : 1907 E HIGHWAY 10 STE B
Second Line :
City : GROVE
State : OK
Zip : 74344-4127
Country : US
Telephone Number : 620-515-1080
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RAYMOND L MORAN
Credential : LPC
Telephone Number : 620-515-1080
Provider Enumeration Date : 07/14/2022
Last Update Date : 11/20/2024

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Directions to “PEAK PERFORMANCE COUNSELING AND CONSULTING LLC ” Practice Location

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