| Ehome Behavioral Care | |
|
4700 Millenia Blvd Ste 175 Orlando FL 32839-6015 | |
| (833) 403-4663 | |
| (888) 853-7908 |
| Full Name | Ehome Behavioral Care |
|---|---|
| Speciality | Counselor |
| Location | 4700 Millenia Blvd Ste 175, Orlando, Florida |
| Authorized Official Name and Position | Rogers Kirven (FOUNDER) |
| Authorized Official Contact | 3212978770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ehome Behavioral Care 4700 Millenia Blvd Ste 175 Orlando FL 32839-6015 Ph: (833) 403-4663 | Ehome Behavioral Care 4700 Millenia Blvd Ste 175 Orlando FL 32839-6015 Ph: (833) 403-4663 |
| NPI Number | 1538609003 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 9133541964 |
|---|---|
| Medicare Enrollment ID | O20200623003209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538609003 | NPI | - | NPPES |
| Provider Name | Tammy M Bolles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669980439 PECOS PAC ID: 5698100071 Enrollment ID: I20200121000345 |
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