| Tea Of Life Holistic Behavioral Health Therapy, Llc | |
|
34124 Burwood Dr Spanish Fort AL 36527-7301 | |
| (251) 401-5602 | |
| Not Available |
| Full Name | Tea Of Life Holistic Behavioral Health Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 34124 Burwood Dr, Spanish Fort, Alabama |
| Authorized Official Name and Position | Tunisia London (OWNER) |
| Authorized Official Contact | 2514015602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tea Of Life Holistic Behavioral Health Therapy, Llc 34124 Burwood Dr Spanish Fort AL 36527-7301 Ph: (251) 401-5602 | Tea Of Life Holistic Behavioral Health Therapy, Llc 34124 Burwood Dr Spanish Fort AL 36527-7301 Ph: (251) 401-5602 |
| NPI Number | 1275284481 |
|---|---|
| Provider Enumeration Date | 01/10/2022 |
| Last Update Date | 01/11/2022 |
| Certification Date | 01/11/2022 |
| Medicare PECOS PAC ID | 5395139331 |
|---|---|
| Medicare Enrollment ID | O20220308001461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275284481 | NPI | - | NPPES |
| Provider Name | Tunisia Weaver London |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902398274 PECOS PAC ID: 5193150712 Enrollment ID: I20220308001663 |
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