Provider Demographics
NPI:1801045117
Name:TEENS EMPOWERMENT AWARENESS WITH RESOLUTIONS, INC
Entity type:Organization
Organization Name:TEENS EMPOWERMENT AWARENESS WITH RESOLUTIONS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:COFAYE
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-291-6363
Mailing Address - Street 1:1011 S RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-6220
Mailing Address - Country:US
Mailing Address - Phone:334-291-6363
Mailing Address - Fax:334-291-6399
Practice Address - Street 1:1011 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-6220
Practice Address - Country:US
Practice Address - Phone:334-291-6363
Practice Address - Fax:334-291-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health