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1433 Brookside Ave Kissimmee FL 34744-2708 | |
| (321) 443-8411 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1433 Brookside Ave, Kissimmee, Florida |
| Authorized Official Name and Position | Carrie Marie Houseman (OWNER) |
| Authorized Official Contact | 3214438411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1433 Brookside Ave Kissimmee FL 34744-2708 Ph: (321) 443-8411 | 1433 Brookside Ave Kissimmee FL 34744-2708 Ph: (321) 443-8411 |
| NPI Number | 1043581903 |
|---|---|
| Provider Enumeration Date | 01/24/2012 |
| Last Update Date | 01/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043581903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 11085 (Florida) | Primary |
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