| Out Of Eden Llc | |
|
1215 Jefferson St Unit 1 Lynchburg VA 24504-1857 | |
| (434) 515-0233 | |
| Not Available |
| Full Name | Out Of Eden Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1215 Jefferson St Unit 1, Lynchburg, Virginia |
| Authorized Official Name and Position | Kendria Eden Johnson (OWNER) |
| Authorized Official Contact | 2762025387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Out Of Eden Llc 103 E Otter Ridge Dr Goode VA 24556-2006 Ph: (276) 202-5387 | Out Of Eden Llc 1215 Jefferson St Unit 1 Lynchburg VA 24504-1857 Ph: (434) 515-0233 |
| NPI Number | 1477302958 |
|---|---|
| Provider Enumeration Date | 05/16/2024 |
| Last Update Date | 05/16/2024 |
| Certification Date | 05/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477302958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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