Provider Demographics
NPI:1770257446
Name:THE WELLNESS FACTORY COUNSELING & CONSULTING LLC.
Entity Type:Organization
Organization Name:THE WELLNESS FACTORY COUNSELING & CONSULTING LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TEAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:205-200-4848
Mailing Address - Street 1:104 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35127-2728
Mailing Address - Country:US
Mailing Address - Phone:205-200-4848
Mailing Address - Fax:
Practice Address - Street 1:104 ELM ST
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:AL
Practice Address - Zip Code:35127-2728
Practice Address - Country:US
Practice Address - Phone:205-200-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty