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3817 White Heron Dr Orlando FL 32808-2605 | |
| (407) 448-3665 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3817 White Heron Dr, Orlando, Florida |
| Authorized Official Name and Position | Donovan D. Davis (PRESIDENT) |
| Authorized Official Contact | 4074483665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3817 White Heron Dr Orlando FL 32808-2605 Ph: (407) 655-7402 | 3817 White Heron Dr Orlando FL 32808-2605 Ph: (407) 448-3665 |
| NPI Number | 1730704933 |
|---|---|
| Provider Enumeration Date | 06/12/2020 |
| Last Update Date | 10/29/2020 |
| Certification Date | 10/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730704933 | NPI | - | NPPES |
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