| Authentic Living Center, Llc | |
|
25400 Us Highway 19 N Ste 156 Clearwater FL 33763-2150 | |
| (727) 480-0107 | |
| (727) 499-7555 |
| Full Name | Authentic Living Center, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 25400 Us Highway 19 N Ste 156, Clearwater, Florida |
| Authorized Official Name and Position | Karmivis Santiago (CEO/PROVIDER) |
| Authorized Official Contact | 7274800107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Living Center, Llc 25400 Us Highway 19 N Ste 156 Clearwater FL 33763-2150 Ph: (727) 480-0107 | Authentic Living Center, Llc 25400 Us Highway 19 N Ste 156 Clearwater FL 33763-2150 Ph: (727) 480-0107 |
| NPI Number | 1962117101 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 04/26/2023 |
| Certification Date | 04/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962117101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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