NPI 1063606028

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Organisation Mental Illness Community Based Residential Treatment Facility Clearwater, FL

Practice location

Address: 2690 Meadow Oak Drive, Clearwater, FL 33761
Phone: (727) 230-9946
Fax: (727) 796-5282

Authorised official

Name: Rose Pamintuan Waje
Title: Owner Administrator
Phone: (727) 230-9946

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 692450696 (FL)

Other Community Based Residential Treatment Facility, Mental Illness providers in Florida →

Registry record

NPI: 1063606028
Entity type: Organization
NPI issued: 4 Sep 2007
Record last updated: 21 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.