Awakened Life Healing, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Kirkwood, MO. Organization (NPI-2).
NPI number1366073546
StatusActive
Last updated in NPPESJan 28, 2020
Details
- NPI
- 1366073546
- Entity type
- Organization (NPI-2)
- Legal business name
- Awakened Life Healing, LLC
- Organization subpart
- No
- Enumeration date
- Jan 28, 2020
- Certification date
- Jan 28, 2020
- Last updated
- Jan 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
10801 Big Bend RdKirkwood, MO 63122-6055
Phone 314-467-0441 · Fax 314-677-3512
Mailing address
597 Summit View DrFenton, MO 63026-3847
Phone 314-640-5846 · Fax 314-677-3512
Authorized official
Sarah Buehner
Owner
4103038946
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