Provider Demographics
NPI:1083158299
Name:EPOCH JOURNEY LLC
Entity Type:Organization
Organization Name:EPOCH JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL LICENSED SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-223-6222
Mailing Address - Street 1:5310 CHEMIN DE VIE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2560
Mailing Address - Country:US
Mailing Address - Phone:786-223-6222
Mailing Address - Fax:786-272-0511
Practice Address - Street 1:1050 CROWN POINTE PKWY STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7702
Practice Address - Country:US
Practice Address - Phone:786-223-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW13022251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health