| Bombora Therapy, Llc | |
|
4400 Marsh Landing Blvd Ste 203 Ponte Vedra Beach FL 32082-1287 | |
| (904) 834-0515 | |
| Not Available |
| Full Name | Bombora Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4400 Marsh Landing Blvd Ste 203, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Matthew Hood (OWNER) |
| Authorized Official Contact | 9048340515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bombora Therapy, Llc 4400 Marsh Landing Blvd Ste 203 Ponte Vedra Beach FL 32082-1287 Ph: () - | Bombora Therapy, Llc 4400 Marsh Landing Blvd Ste 203 Ponte Vedra Beach FL 32082-1287 Ph: (904) 834-0515 |
| NPI Number | 1124863006 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124863006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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