Organization Name: | COUNTRY BREEZE COUNSELING CENTER, LLC |
NPI Number: | 1417281643 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA BECK GRANATO (OWNER-COUNSELOR) |
Mailing Address: | 16486 Fm 463 Lytle |
State: | TX US |
Postal Code: | 780524514 |
Phone Number: | 8307090711 |
Fax Number: | 8307723808 |
NPI Enumeration Date: | 09/21/2009 |
NPI Last Update Date: | 09/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 63654 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |