Provider Demographics
NPI:1437907441
Name:OVERHAUL LIFE LLC
Entity type:Organization
Organization Name:OVERHAUL LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-664-9780
Mailing Address - Street 1:1835 PARKER RD APT 1301
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4800
Mailing Address - Country:US
Mailing Address - Phone:469-631-6478
Mailing Address - Fax:
Practice Address - Street 1:6009 W PARKER RD STE 149-1207
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8120
Practice Address - Country:US
Practice Address - Phone:469-631-6478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)