# TEA OF LIFE HOLISTIC BEHAVIORAL HEALTH THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275284481
- **Authorized official:** TUNISIA LONDON LICSW, PIP (OWNER)
- **Authorized official phone:** (251) 401-5602

## Contact information

- **Practice address:** 34124 BURWOOD DR, SPANISH FORT, AL 36527-7301
- **Practice address phone:** (251) 401-5602
- **Mailing address:** 34124 BURWOOD DR, SPANISH FORT, AL 36527-7301
- **Mailing address phone:** (251) 401-5602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/10/2022
- **Last updated:** 01/11/2022