Provider Demographics
NPI:1013576172
Name:VIATRU LIFE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:VIATRU LIFE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:WASHAUNDRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, PIP
Authorized Official - Phone:833-484-2878
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:FOSTERS
Mailing Address - State:AL
Mailing Address - Zip Code:35463-0342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3915 PALISADES DR STE B
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3415
Practice Address - Country:US
Practice Address - Phone:833-484-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty