Organization
THE LIFE COUNSELING CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN HAAS (BUSINESS ADMINISTRATOR)
(828) 647-5433
Entity
Organization
Contact information
Practice address
124 LIFE WAY, CLYDE, NC 28721-6540
(828) 647-5433
Mailing address
124 LIFE WAY, CLYDE, NC 28721-6540
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MHL-044-042
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300647H
—
NC
Enumeration date
09/10/2007
Last updated
09/10/2007
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