Provider Demographics
NPI:1093594343
Name:A COUPLES PLACE, INC
Entity Type:Organization
Organization Name:A COUPLES PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:415-721-4310
Mailing Address - Street 1:7912 LOWELL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-9772
Mailing Address - Country:US
Mailing Address - Phone:415-721-4310
Mailing Address - Fax:
Practice Address - Street 1:7912 LOWELL VALLEY DR
Practice Address - Street 2:
Practice Address - City:BAHAMA
Practice Address - State:NC
Practice Address - Zip Code:27503-9772
Practice Address - Country:US
Practice Address - Phone:707-477-1434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty