| Lake Psychoeducational Center | |
|
600 N Highway 27 Ste 1 Minneola FL 34715-6265 | |
| (407) 209-7492 | |
| (352) 241-8372 |
| Full Name | Lake Psychoeducational Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 600 N Highway 27 Ste 1, Minneola, Florida |
| Authorized Official Name and Position | Grace Pena (PRESIDENT) |
| Authorized Official Contact | 4072097492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Psychoeducational Center 600 N Highway 27 Ste 1 Minneola FL 34715-6265 Ph: (407) 209-7492 | Lake Psychoeducational Center 600 N Highway 27 Ste 1 Minneola FL 34715-6265 Ph: (407) 209-7492 |
| NPI Number | 1417341488 |
|---|---|
| Provider Enumeration Date | 03/26/2015 |
| Last Update Date | 03/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417341488 | NPI | - | NPPES |
| 762627400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH5773 (Florida) | Primary |
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