| Positively Aba, Llc | |
|
5301 18th Ave S Gulfport FL 33707-4216 | |
| (727) 772-3053 | |
| Not Available |
| Full Name | Positively Aba, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5301 18th Ave S, Gulfport, Florida |
| Authorized Official Name and Position | Laura Susan Klich Henderson (OWNER) |
| Authorized Official Contact | 7277723053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Positively Aba, Llc 5301 18th Ave S Gulfport FL 33707-4216 Ph: (727) 772-3053 | Positively Aba, Llc 5301 18th Ave S Gulfport FL 33707-4216 Ph: (727) 772-3053 |
| NPI Number | 1063236941 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 11/08/2024 |
| Certification Date | 11/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063236941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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