The Mending Place, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE MENDING PLACE, LLC

Practice address

113 E Fontana Cir
Dothan, AL 36305-8301

Phone

(334) 790-2133

NPI assigned

Sep 14, 2022

Last updated

Sep 14, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samantha BoldenNPI 1962059998

Title

Owner

Phone

(334) 790-2133

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samantha Nicole Bolden

  • Professional Counselor
  • Dothan, AL
  • NPI 1962059998
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1710609953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E FONTANA CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363058301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E FONTANA CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363058301",
            "telephone_number": "334-790-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MENDING PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BOLDEN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-790-2133"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Dothan, AL
• Providers in Dothan, AL by specialty
• Community/Behavioral Health Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.