Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Acupuncturist |
171100000X |
| NPI Number | 1275037277 |
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| LBN Legal business name | EDEN THERAPY CENTER, LLC | ||||||||||||
| Authorized official | NANCY LOWE - (OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 03/23/2018 | ||||||||||||
| Last updated | 01/30/2019 - About 7 years ago | ||||||||||||
| Identifiers |
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