ELEMENTAL LIBERATION NPI 1669132395

NPI Information

NPI: 1669132395
Provider Name: ELEMENTAL LIBERATION
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
2703 SOL WILSON AVE
AUSTIN, TX
ZIP 78702
Phone: (512) 650-8179
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ELEMENTAL LIBERATION is a mental health (including community mental health center) clinic center in Austin, TX. ELEMENTAL LIBERATION NPI is 1669132395. The provider is registered as an organization entity type.

The provider's business location address is:

2703 SOL WILSON AVE
AUSTIN, TX
ZIP 78702-556
Phone: (512) 650-8179

The provider's authorized official is Vanessa Rosage .
The authorized official title is Owner and has the following contact phone number (512) 650-8179.

The enumeration date for this NPI number is 12/21/2021 and was last updated on 12/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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