| Organization Name: | TRAUMACARE INSTITUTE, PLLC |
| NPI Number: | 1275990368 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL SHANE LUCK (OWNER/MANAGER) |
| Mailing Address: | 61 West Center Street Snowflake |
| State: | AZ US |
| Postal Code: | 85937 |
| Phone Number: | 4805106780 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2016 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC-15864 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |