Provider Demographics
NPI:1063269025
Name:CLOSER WALK REENTRY & ADVOCACY PROGRAM INC.
Entity type:Organization
Organization Name:CLOSER WALK REENTRY & ADVOCACY PROGRAM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/MS ADDICTION COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:PATRION
Authorized Official - Last Name:NZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-789-9197
Mailing Address - Street 1:PO BOX 51202
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-1202
Mailing Address - Country:US
Mailing Address - Phone:865-789-9197
Mailing Address - Fax:
Practice Address - Street 1:3010 E MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-4503
Practice Address - Country:US
Practice Address - Phone:865-789-9197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management