Center For A Healthy Mind And Wellbeing Llc | |
1677 Wells Rd Suite A Orange Park FL 32073-6799 | |
(904) 272-0043 | |
(904) 272-0045 |
Full Name | Center For A Healthy Mind And Wellbeing Llc |
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Speciality | Psychiatry & Neurology |
Location | 1677 Wells Rd, Orange Park, Florida |
Authorized Official Name and Position | Ginger Hudnall (OFFICE ADMINISTRATOR) |
Authorized Official Contact | 9045278777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Center For A Healthy Mind And Wellbeing Llc 1677 Wells Rd Suite A Orange Park FL 32073-6799 Ph: (904) 272-0043 | Center For A Healthy Mind And Wellbeing Llc 1677 Wells Rd Suite A Orange Park FL 32073-6799 Ph: (904) 272-0043 |
NPI Number | 1710243571 |
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Provider Enumeration Date | 04/05/2012 |
Last Update Date | 09/19/2019 |
Medicare PECOS PAC ID | 0143476044 |
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Medicare Enrollment ID | O20120808000869 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710243571 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | ME108768 (Florida) | Primary |
Provider Name | Louise A Axelberg |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1124074729 PECOS PAC ID: 6901903558 Enrollment ID: I20070516000532 |
Provider Name | Marcus Decarvalho |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427213727 PECOS PAC ID: 6002088457 Enrollment ID: I20120816000122 |
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