| Bethlehem Family Services. | |
|
2103 Mud Lake Rd Plant City FL 33566-1009 | |
| (813) 752-4591 | |
| Not Available |
| Full Name | Bethlehem Family Services. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2103 Mud Lake Rd, Plant City, Florida |
| Authorized Official Name and Position | Jomo Zm Thomas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3138062852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethlehem Family Services. 5202 Coto Pl Valrico FL 33596-8264 Ph: (313) 806-2852 | Bethlehem Family Services. 2103 Mud Lake Rd Plant City FL 33566-1009 Ph: (813) 752-4591 |
| NPI Number | 1932918927 |
|---|---|
| Provider Enumeration Date | 01/03/2025 |
| Last Update Date | 01/03/2025 |
| Certification Date | 01/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932918927 | NPI | - | NPPES |
| 1336278134 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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