Organization Name: | TOTAL LIFE CLINICIANS, LLC |
NPI Number: | 1508890351 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREENBRIER DAVID RALPH ALMOND (OWNER) |
Mailing Address: | Rt 4 & 20 South 2nd Floor Rock Cave |
State: | WV US |
Postal Code: | 26234 |
Phone Number: | 3044738988 |
Fax Number: | 3044729849 |
NPI Enumeration Date: | 07/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |