Larry Porta LLC
Counselor, Mental Health in Gaylord, MI. Organization (NPI-2).
NPI number1639729262
StatusActive
Last updated in NPPESSep 16, 2019
Details
- NPI
- 1639729262
- Entity type
- Organization (NPI-2)
- Legal business name
- Larry Porta LLC
- Organization subpart
- No
- Enumeration date
- Sep 16, 2019
- Last updated
- Sep 16, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – |
Other names
- Larry Porta Counseling Services (Doing Business As)
Practice location
440 W Main St Ste CGaylord, MI 49735-1885
Phone 989-448-2640 · Fax 989-448-2639
Mailing address
440 W Main St Ste CGaylord, MI 49735-1885
Phone 989-448-2640 · Fax 989-448-2639
Authorized official
Larry Porta
Owner
9894482640
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