Organization
REVELATIONS TREATMENT CENTER, LLC
Active
Other names
Corporate Consulting & Coaching, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI BETH LONG M.ED. (LICENSED MENTAL HEALTH COUNSELOR)
(561) 360-5050
Entity
Organization
Contact information
Practice address
521 LANTANA RD, LANTANA, FL 33462-1625
(561) 360-5050
Mailing address
521 LANTANA RD, LANTANA, FL 33462-1625
(561) 360-5050
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH2035
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH2035
LICENSED MENTAL HEALTH COUNSELOR
FL
Enumeration date
10/11/2016
Last updated
10/11/2016
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