Provider Demographics
NPI:1275093767
Name:MOMENT TO MOMENT HEALING ALTERNATIVES, LLC
Entity Type:Organization
Organization Name:MOMENT TO MOMENT HEALING ALTERNATIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ZASHATA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:651-380-0043
Mailing Address - Street 1:217 PLUM ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2340
Mailing Address - Country:US
Mailing Address - Phone:651-380-0043
Mailing Address - Fax:651-800-2000
Practice Address - Street 1:217 PLUM ST STE 100
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2340
Practice Address - Country:US
Practice Address - Phone:651-380-0043
Practice Address - Fax:651-800-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty