Organization
SEQUEL ALLIANCE FAMILY SERVICES, LLC
Active
Parent organization
SEQUEL TSI HOLDING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEQUEL TSI HOLDING, LLC
Authorized official
MS. MARY CAUDLE (CBO DIRECTOR OF PATIENT ACCOUNTS)
(256) 880-3339
Entity
Organization
Contact information
Practice address
89 HOMER DR, ST MARIES, ID 83861-5078
(208) 245-5427
(208) 245-5427
Mailing address
1131 EAGLETREE LN SW, HUNTSVILLE, AL 35801-6478
(256) 880-3339
(256) 880-9569
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W132383
STATE LICENSE NUMBER
—
Enumeration date
01/16/2014
Last updated
01/17/2014
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