Provider Demographics
NPI:1932917754
Name:TOTAL ABSTINENCE LLC
Entity type:Organization
Organization Name:TOTAL ABSTINENCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUMAANE
Authorized Official - Middle Name:JEWEL O'HANALAWAY
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:APSS
Authorized Official - Phone:248-571-1754
Mailing Address - Street 1:230 BATTLEFIELD MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8338
Mailing Address - Country:US
Mailing Address - Phone:859-408-7031
Mailing Address - Fax:
Practice Address - Street 1:230 BATTLEFIELD MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8338
Practice Address - Country:US
Practice Address - Phone:859-408-7031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health