Organization Name: | THERAPEUTIC COLLABORATIVE |
NPI Number: | 1629123443 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VIRGINIA ELLEN PEPPERS (PARTNER) |
Mailing Address: | 519 Licking Pike Wilder |
State: | KY US |
Postal Code: | 41071 |
Phone Number: | 8595720400 |
Fax Number: | 8594423363 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 06/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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. |