| Daniels Harbor Therapy Center Llc | |
|
1754 Sea Lark Ln Navarre FL 32566-7406 | |
| (850) 780-3496 | |
| (850) 462-2094 |
| Full Name | Daniels Harbor Therapy Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1754 Sea Lark Ln, Navarre, Florida |
| Authorized Official Name and Position | Niesia Deshae Garza (LCSW, OWNER) |
| Authorized Official Contact | 8507803496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniels Harbor Therapy Center Llc 1754 Sea Lark Ln Navarre FL 32566-7406 Ph: (850) 780-3496 | Daniels Harbor Therapy Center Llc 1754 Sea Lark Ln Navarre FL 32566-7406 Ph: (850) 780-3496 |
| NPI Number | 1366000416 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 02/07/2020 |
| Certification Date | 02/07/2020 |
| Medicare PECOS PAC ID | 9032446067 |
|---|---|
| Medicare Enrollment ID | O20190813002765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366000416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Niesia Garza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275083313 PECOS PAC ID: 0840576609 Enrollment ID: I20170410000752 |
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