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Organization
SPIRITUAL HEALING LIFE COACH
Active
Organization
SPIRITUAL HEALING LIFE COACH
Active
Other names
Spiritual Healing Sober Living
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY STEVENSON (CEO)
(612) 236-3204
Entity
Organization
Contact information
Practice address
278 7TH ST E, SAINT PAUL, MN 55101-2349
(612) 236-3204
Mailing address
1194 ALBEMARLE ST, SAINT PAUL, MN 55117-4418
(612) 236-3204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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