Provider Demographics
NPI:1275380487
Name:BOTANICAL REIGN LLC
Entity Type:Organization
Organization Name:BOTANICAL REIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIERA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-444-0783
Mailing Address - Street 1:PO BOX 771
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-0771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 ROUTE 73 NORTH SUITE 104
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-444-0783
Practice Address - Fax:856-560-1007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOTANICAL REIGN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management