| Self-awareness, Llc | |
|
2301 Forest Ave Des Moines IA 50311-3113 | |
| (515) 277-0320 | |
| Not Available |
| Full Name | Self-awareness, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2301 Forest Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Jerome Miller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5152770320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self-awareness, Llc 2301 Forest Ave Des Moines IA 50311-3113 Ph: (515) 277-0320 | Self-awareness, Llc 2301 Forest Ave Des Moines IA 50311-3113 Ph: (515) 277-0320 |
| NPI Number | 1336538180 |
|---|---|
| Provider Enumeration Date | 01/16/2015 |
| Last Update Date | 01/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336538180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 14007 (Iowa) | Primary |
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