Provider Demographics
NPI: | 1679195135 |
---|---|
Name: | PRACHAR ENTERPRISES, LLC |
Entity Type: | Organization |
Organization Name: | PRACHAR ENTERPRISES, LLC |
Other - Org Name: | GUARDIAN COUNSELING |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER/MANAGER/COUNSELOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PAUL |
Authorized Official - Middle Name: | MARVIN |
Authorized Official - Last Name: | PRACHAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MA |
Authorized Official - Phone: | 941-214-2230 |
Mailing Address - Street 1: | 329 NOKOMIS AVE S STE H |
Mailing Address - Street 2: | |
Mailing Address - City: | VENICE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34285-2418 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 941-214-2230 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 329 NOKOMIS AVE S STE H |
Practice Address - Street 2: | |
Practice Address - City: | VENICE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34285-2418 |
Practice Address - Country: | US |
Practice Address - Phone: | 941-214-2230 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-05-07 |
Last Update Date: | 2023-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |