Provider Demographics
NPI:1467158436
Name:CARPE DIEM SELF IMPROVEMENT CENTER
Entity Type:Organization
Organization Name:CARPE DIEM SELF IMPROVEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:LEDWELL
Authorized Official - Last Name:MARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:423-641-8519
Mailing Address - Street 1:155 EAGLE CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-6385
Mailing Address - Country:US
Mailing Address - Phone:423-641-8519
Mailing Address - Fax:423-650-4813
Practice Address - Street 1:155 EAGLE CREEK RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-6385
Practice Address - Country:US
Practice Address - Phone:423-641-8519
Practice Address - Fax:423-650-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty