Provider Demographics
NPI:1508216938
Name:VAN ACKEREN CONSULTING, LLC
Entity Type:Organization
Organization Name:VAN ACKEREN CONSULTING, LLC
Other - Org Name:PERSONALIZED PREVENTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VAN ACKEREN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:210-852-6205
Mailing Address - Street 1:1100 NW LOOP 410
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 NW LOOP 410
Practice Address - Street 2:SUITE 270
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213
Practice Address - Country:US
Practice Address - Phone:210-481-7584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty