Provider Demographics
NPI:1407048184
Name:AWAKENING A CENTER FOR EXPLORING LIVING AND DYING
Entity Type:Organization
Organization Name:AWAKENING A CENTER FOR EXPLORING LIVING AND DYING
Other - Org Name:AWAKENING COUNSELING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:925-933-7171
Mailing Address - Street 1:9701 DEER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4947
Mailing Address - Country:US
Mailing Address - Phone:925-634-9890
Mailing Address - Fax:
Practice Address - Street 1:9701 DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-4947
Practice Address - Country:US
Practice Address - Phone:925-634-9890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty