| Lake Wellness, Llc | |
|
590 Solutions Way Ste 120 Rockledge FL 32955-3623 | |
| (321) 626-4513 | |
| Not Available |
| Full Name | Lake Wellness, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 590 Solutions Way Ste 120, Rockledge, Florida |
| Authorized Official Name and Position | Michael H Lake (PRESIDENT) |
| Authorized Official Contact | 3216264513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Wellness, Llc 590 Solutions Way Ste 120 Rockledge FL 32955-3623 Ph: (321) 626-4513 | Lake Wellness, Llc 590 Solutions Way Ste 120 Rockledge FL 32955-3623 Ph: (321) 626-4513 |
| NPI Number | 1528896958 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528896958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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