Provider Demographics
NPI:1487025482
Name:AMERICAN ASSOCIATION OF INTEGRATIVE & PASTORAL MEDICINE
Entity Type:Organization
Organization Name:AMERICAN ASSOCIATION OF INTEGRATIVE & PASTORAL MEDICINE
Other - Org Name:EDENIC LIGHT INTEGRATIVE FAMILY LIFE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALOMIM
Authorized Official - Middle Name:YAHOSHUA
Authorized Official - Last Name:HALAHAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD(AM), ND, OMD PSYD
Authorized Official - Phone:678-909-4422
Mailing Address - Street 1:3695 CASCADE RD SW # 117F
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2173
Mailing Address - Country:US
Mailing Address - Phone:678-909-4422
Mailing Address - Fax:866-357-6267
Practice Address - Street 1:3695 CASCADE RD SW # 117F
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2173
Practice Address - Country:US
Practice Address - Phone:678-909-4422
Practice Address - Fax:866-357-6267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIZRAHI JEWISH INTERNATIONAL RABBINICAL COUNCIL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable