Provider Demographics
NPI:1083500615
Name:EMBER & TIDE ORCHARD COLLECTIVE, LLC
Entity type:Organization
Organization Name:EMBER & TIDE ORCHARD COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:CISNEROZ
Authorized Official - Last Name:BRACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-235-2949
Mailing Address - Street 1:707 HILLTOP ST
Mailing Address - Street 2:
Mailing Address - City:BAIRD
Mailing Address - State:TX
Mailing Address - Zip Code:79504-2355
Mailing Address - Country:US
Mailing Address - Phone:817-235-2949
Mailing Address - Fax:
Practice Address - Street 1:1998 INDUSTRIAL BLVD STE C
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7848
Practice Address - Country:US
Practice Address - Phone:325-266-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty