| NPI | 1578091104 |
|---|---|
| Doing Business As | LONGBRANCH WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | EMILY ELIZABETH MEYERS CEO 920-309-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center Recovery Care |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2024-01-18 |