| Reconstructed Minds, Llc | |
|
22436 Southshore Dr Land O Lakes FL 34639-4638 | |
| (304) 654-7557 | |
| Not Available |
| Full Name | Reconstructed Minds, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 22436 Southshore Dr, Land O Lakes, Florida |
| Authorized Official Name and Position | Terry Danielson (CEO) |
| Authorized Official Contact | 7406462580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reconstructed Minds, Llc 22436 Southshore Dr Land O Lakes FL 34639-4638 Ph: (304) 654-7557 | Reconstructed Minds, Llc 22436 Southshore Dr Land O Lakes FL 34639-4638 Ph: (304) 654-7557 |
| NPI Number | 1336822584 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336822584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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