Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Family |
363LF0000X | 50 | Nurse Practitioner | |
Professional |
101YP2500X | |||
Pulmonary Disease |
207RP1001X | 11 | Physician/Internal Medicine |
| NPI # | 1578119996 |
| LBN Legal business name | FOREVER WELLNESS & RECOVERY LLC |
| Authorized official | BRIAN HOLLINS - (COO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/12/2019 |
| Last updated | 05/01/2023 - About 3 years ago |
| Identifiers | n/a |
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