Provider Demographics
NPI:1043570666
Name:ADDICTION AWARENESS
Entity Type:Organization
Organization Name:ADDICTION AWARENESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CRADC
Authorized Official - Phone:816-205-0082
Mailing Address - Street 1:PO BOX 8843
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64508-8843
Mailing Address - Country:US
Mailing Address - Phone:816-205-0082
Mailing Address - Fax:
Practice Address - Street 1:3442 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-1333
Practice Address - Country:US
Practice Address - Phone:816-205-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health