| 11911 Pine Forest Drive, New Port Ritchey 34654 | |
|
11911 Pine Forest Dr New Port Richey FL 34654-1462 | |
| (813) 526-4155 | |
| Not Available |
| Full Name | 11911 Pine Forest Drive, New Port Ritchey 34654 |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 11911 Pine Forest Dr, New Port Richey, Florida |
| Authorized Official Name and Position | Neveh Mahilum (OWNER/MANAGER) |
| Authorized Official Contact | 8135264155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 11911 Pine Forest Drive, New Port Ritchey 34654 10144 Arbor Run Dr Unit 28 Tampa FL 33647-3568 Ph: (813) 526-4155 | 11911 Pine Forest Drive, New Port Ritchey 34654 11911 Pine Forest Dr New Port Richey FL 34654-1462 Ph: (813) 526-4155 |
| NPI Number | 1912532441 |
|---|---|
| Provider Enumeration Date | 03/04/2020 |
| Last Update Date | 03/16/2020 |
| Certification Date | 03/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912532441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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