Provider Demographics
NPI: | 1538682273 |
---|---|
Name: | ENCOMPASS COUNSELING, WELLNESS AND REHAB |
Entity type: | Organization |
Organization Name: | ENCOMPASS COUNSELING, WELLNESS AND REHAB |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VICTORIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROSS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 478-333-2735 |
Mailing Address - Street 1: | 96B TOMMY STALNAKER DRIVE |
Mailing Address - Street 2: | |
Mailing Address - City: | WARNER ROBINS |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 31088-8030 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 478-333-2735 |
Mailing Address - Fax: | 478-333-2744 |
Practice Address - Street 1: | 96B TOMMY STALNAKER DRIVE |
Practice Address - Street 2: | |
Practice Address - City: | WARNER ROBINS |
Practice Address - State: | GA |
Practice Address - Zip Code: | 31088 |
Practice Address - Country: | US |
Practice Address - Phone: | 478-333-2735 |
Practice Address - Fax: | 478-333-2744 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-07-25 |
Last Update Date: | 2018-08-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |