| Inner Awakening Therapy Center Llc | |
|
1575 Detrick Ave Deland FL 32724-2042 | |
| (407) 906-8633 | |
| Not Available |
| Full Name | Inner Awakening Therapy Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1575 Detrick Ave, Deland, Florida |
| Authorized Official Name and Position | Adel M Ceballos-rosario (OWNER) |
| Authorized Official Contact | 4079068633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Awakening Therapy Center Llc 1575 Detrick Ave Deland FL 32724-2042 Ph: (407) 906-8633 | Inner Awakening Therapy Center Llc 1575 Detrick Ave Deland FL 32724-2042 Ph: (407) 906-8633 |
| NPI Number | 1205325297 |
|---|---|
| Provider Enumeration Date | 05/04/2018 |
| Last Update Date | 10/04/2021 |
| Certification Date | 10/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205325297 | NPI | - | NPPES |
| 1205325297 | Medicaid | FL |
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