| Breaking Dawn Llc | |
|
116 Wilkerson Ave Madison AL 35756-4280 | |
| (256) 490-4443 | |
| (256) 262-4637 |
| Full Name | Breaking Dawn Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 116 Wilkerson Ave, Madison, Alabama |
| Authorized Official Name and Position | Misty Deramus (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2564904443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breaking Dawn Llc 116 Wilkerson Ave Madison AL 35756-4280 Ph: (256) 490-4443 | Breaking Dawn Llc 116 Wilkerson Ave Madison AL 35756-4280 Ph: (256) 490-4443 |
| NPI Number | 1245734342 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 03/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245734342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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