| Providencepass, Llc | |
|
741 Front St Ste 210 Kissimmee FL 34747-4992 | |
| (844) 244-2840 | |
| Not Available |
| Full Name | Providencepass, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 741 Front St Ste 210, Kissimmee, Florida |
| Authorized Official Name and Position | Jennifer Del Giudice (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8442442840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providencepass, Llc 741 Front St Ste 210 Kissimmee FL 34747-4992 Ph: (844) 244-2840 | Providencepass, Llc 741 Front St Ste 210 Kissimmee FL 34747-4992 Ph: (844) 244-2840 |
| NPI Number | 1811554546 |
|---|---|
| Provider Enumeration Date | 05/29/2019 |
| Last Update Date | 05/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811554546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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