Whalio Doctors

NPI 1528415247

Parent Support, LLC

Organisation Mental Illness Community Based Residential Treatment Facility Davenport, FL

Practice location

Address
389 Sand Ridge Dr, Davenport, FL 33896-4717
Phone
(407) 901-4000
Fax
(407) 930-4830

Authorised official

Name
Vickki-Ann S. Samuel
Title
Medical Director
Phone
(407) 901-4000

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X Licence CARF ACCREDITED (FL)

Registry record

NPI
1528415247
Entity type
Organization
NPI issued
23 May 2016
Record last updated
23 May 2016

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.