Provider Demographics
NPI:1689406381
Name:PAPER CRANE WELLNESS, LLC
Entity type:Organization
Organization Name:PAPER CRANE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:PHILLIIPS
Authorized Official - Last Name:TOZER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:803-606-0342
Mailing Address - Street 1:1007 JOHNNIE DODDS BLVD # B13
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6123
Mailing Address - Country:US
Mailing Address - Phone:843-256-2016
Mailing Address - Fax:
Practice Address - Street 1:1007 JOHNNIE DODDS BLVD STE 129
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5901
Practice Address - Country:US
Practice Address - Phone:432-562-0168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health