| The Mending Place, Llc | |
|
113 E Fontana Cir Dothan AL 36305-8301 | |
| (334) 790-2133 | |
| Not Available |
| Full Name | The Mending Place, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 113 E Fontana Cir, Dothan, Alabama |
| Authorized Official Name and Position | Samantha Bolden (OWNER) |
| Authorized Official Contact | 3347902133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mending Place, Llc 113 E Fontana Cir Dothan AL 36305-8301 Ph: () - | The Mending Place, Llc 113 E Fontana Cir Dothan AL 36305-8301 Ph: (334) 790-2133 |
| NPI Number | 1710609953 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710609953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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