Provider Demographics
NPI:1114568987
Name:HOUSE OF RESCUE COUNSELING
Entity Type:Organization
Organization Name:HOUSE OF RESCUE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFFOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ICRC-ADC, ALC
Authorized Official - Phone:334-200-3510
Mailing Address - Street 1:PO BOX 10408
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36304-2408
Mailing Address - Country:US
Mailing Address - Phone:334-200-3510
Mailing Address - Fax:
Practice Address - Street 1:210 CROSSING LN
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-5541
Practice Address - Country:US
Practice Address - Phone:334-200-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALDW4UQC5CFMedicaid