Provider Demographics
NPI:1306566450
Name:VERVE, LLC
Entity type:Organization
Organization Name:VERVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASTRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOLSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPP, LIFESTYLE COACH
Authorized Official - Phone:662-202-6361
Mailing Address - Street 1:2906 N STATE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4231
Mailing Address - Country:US
Mailing Address - Phone:601-308-4220
Mailing Address - Fax:
Practice Address - Street 1:2906 N STATE ST STE 105
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4231
Practice Address - Country:US
Practice Address - Phone:601-308-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty