Provider Demographics
NPI:1912640194
Name:SONFOREVER
Entity Type:Organization
Organization Name:SONFOREVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:EALEY
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:770-480-2522
Mailing Address - Street 1:894 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-1854
Mailing Address - Country:US
Mailing Address - Phone:334-794-2113
Mailing Address - Fax:
Practice Address - Street 1:894 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HEADLAND
Practice Address - State:AL
Practice Address - Zip Code:36345-1854
Practice Address - Country:US
Practice Address - Phone:334-794-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty