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5319 Grand Blvd New Port Richey FL 34652 | |
| (727) 220-2422 | |
| (727) 264-0462 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5319 Grand Blvd, New Port Richey, Florida |
| Authorized Official Name and Position | Kevin Simmons (CEO) |
| Authorized Official Contact | 7272202422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5319 Grand Blvd New Port Richey FL 34652 Ph: (727) 220-2422 | 5319 Grand Blvd New Port Richey FL 34652 Ph: (727) 220-2422 |
| NPI Number | 1962904409 |
|---|---|
| Provider Enumeration Date | 03/01/2018 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962904409 | NPI | - | NPPES |
| 023393600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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