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621 Boll Weevil Cir Ste 33 Enterprise AL 36330-2749 | |
| (334) 475-2422 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 621 Boll Weevil Cir Ste 33, Enterprise, Alabama |
| Authorized Official Name and Position | Channing J Starks (OWNER) |
| Authorized Official Contact | 3344326035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
830 N Ouida St Enterprise AL 36330-2704 Ph: (334) 432-6035 | 621 Boll Weevil Cir Ste 33 Enterprise AL 36330-2749 Ph: (334) 475-2422 |
| NPI Number | 1477314524 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477314524 | NPI | - | NPPES |
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