Organization
SPEARHEAD LODGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KAY BAKER MS,LCDC (PRESIDENT)
(972) 835-1963
Entity
Organization
Contact information
Practice address
8455 LYNDON LN, AUSTIN, TX 78729-3704
(512) 278-4940
Mailing address
8455 LYNDON LN, AUSTIN, TX 78729-3704
(512) 278-4940
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4085-4086
TX
Other
Enumeration date
08/19/2016
Last updated
04/13/2022
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