Provider Demographics
NPI:1730736521
Name:EUDEMONIA, PLLC
Entity type:Organization
Organization Name:EUDEMONIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISHAE
Authorized Official - Middle Name:SHAMONE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-274-5642
Mailing Address - Street 1:258 CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-4685
Mailing Address - Country:US
Mailing Address - Phone:269-274-5642
Mailing Address - Fax:269-620-6082
Practice Address - Street 1:340 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3256
Practice Address - Country:US
Practice Address - Phone:269-274-5642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty