Provider Demographics
NPI:1518609676
Name:PHASE 2 ALTERNATIVES COACHING LLC
Entity Type:Organization
Organization Name:PHASE 2 ALTERNATIVES COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - COACH
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-536-0808
Mailing Address - Street 1:3552 PELHAM PARKWAY #1016
Mailing Address - Street 2:B205
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124
Mailing Address - Country:US
Mailing Address - Phone:212-933-0807
Mailing Address - Fax:
Practice Address - Street 1:188 HIDDEN TRACE CT
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-5933
Practice Address - Country:US
Practice Address - Phone:212-933-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty