Raveon1947 | |
9040 Town Center Parkway Bradenton FL 34202-3420 | |
(941) 685-0265 | |
(941) 552-5650 |
Full Name | Raveon1947 |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 9040 Town Center Parkway, Bradenton, Florida |
Authorized Official Name and Position | David L Kaus (OWNER) |
Authorized Official Contact | 9416850265 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Raveon1947 9040 Town Center Pkwy Lakewood Ranch FL 34202-4101 Ph: (941) 685-0265 | Raveon1947 9040 Town Center Parkway Bradenton FL 34202-3420 Ph: (941) 685-0265 |
NPI Number | 1205317930 |
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Provider Enumeration Date | 08/21/2018 |
Last Update Date | 08/21/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205317930 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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