Organization · NPI-2

Awaken360, INC.

Counselor, Professional · Springfield, MO

NPI number1275178451
StatusActive
Last updated in NPPESNov 12, 2019

Details

NPI
1275178451
Entity type
Organization (NPI-2)
Legal business name
Awaken360, INC.
Organization subpart
No
Enumeration date
Nov 12, 2019
Last updated
Nov 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
251B00000X Case Management––

Practice location

829 W Atlantic St
Springfield, MO 65803-1517

Phone 417-251-1750

Mailing address

Po Box 495
Springfield, MO 65801-0495

Phone 417-251-1750

Authorized official

Heather M. Freeman
Founder & Director
4172511750

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