| Elysium Mental Health Llc | |
|
541 Chantilly Trl Bradenton FL 34212-5023 | |
| (941) 448-0596 | |
| (918) 398-9318 |
| Full Name | Elysium Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 541 Chantilly Trl, Bradenton, Florida |
| Authorized Official Name and Position | Marco A Rabines (OWNER) |
| Authorized Official Contact | 9545366390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elysium Mental Health Llc 541 Chantilly Trl Bradenton FL 34212-5023 Ph: (941) 448-0596 | Elysium Mental Health Llc 541 Chantilly Trl Bradenton FL 34212-5023 Ph: (941) 448-0596 |
| NPI Number | 1356080378 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 05/27/2022 |
| Certification Date | 05/27/2022 |
| Medicare PECOS PAC ID | 1153701461 |
|---|---|
| Medicare Enrollment ID | O20220705001324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356080378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Marco A Rabines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780833038 PECOS PAC ID: 5597912055 Enrollment ID: I20140828001414 |
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