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Organization
KING OF HEARTS LIFE ENHANCEMENT SERVICES, LLC
Active
Organization
KING OF HEARTS LIFE ENHANCEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA MICHELLE KING LPC, LCADC (DIRECTOR)
(732) 240-2545
Entity
Organization
Contact information
Practice address
522 BRICK BLVD, BRICK, NJ 08723-6089
(732) 240-2545
(732) 475-6265
Mailing address
522 BRICK BLVD, BRICK, NJ 08723-6089
(732) 240-2545
(732) 475-6265
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00034800
NJ
101YP2500X
Professional Counselor
37PC00161400
NJ
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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