Organization Name: | SHANTI COUNSELING SERVICES, LLC |
NPI Number: | 1174706048 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THERESA MARIE CALLARD-MOORE (PRESIDENT) |
Mailing Address: | 6199 Miller Rd Suite A Swartz Creek |
State: | MI US |
Postal Code: | 484731585 |
Phone Number: | 8106300904 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2007 |
NPI Last Update Date: | 12/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 6801067098 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |