Provider Demographics
NPI:1558022681
Name:ANCHOR OF LIFE MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ANCHOR OF LIFE MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:YOUNG-RICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:765-557-8446
Mailing Address - Street 1:1444 S A ST
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036-1903
Mailing Address - Country:US
Mailing Address - Phone:765-557-8446
Mailing Address - Fax:
Practice Address - Street 1:1444 S A ST
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036-1903
Practice Address - Country:US
Practice Address - Phone:765-557-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)