NPI 1073990982

Rose Souverain

Practitioner Mental Illness Community Based Residential Treatment Facility Ocoee, FL

Practice location

Address: 404 Tranquille Oaks Dr, Ocoee, FL 34761-1402
Phone: (321) 460-4138
Fax: (321) 558-3055

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 6906125 (FL)

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

Registry record

NPI: 1073990982
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Apr 2015
Record last updated: 29 Apr 2015

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.