| Sally's House | |
|
2061 Harbor Ave Ne Palm Bay FL 32905-3114 | |
| (321) 722-5200 | |
| Not Available |
| Full Name | Sally's House |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2061 Harbor Ave Ne, Palm Bay, Florida |
| Authorized Official Name and Position | Fallon Derosa (HR MANAGER) |
| Authorized Official Contact | 3217225273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally's House 400 Sheridan Rd Melbourne FL 32901-3122 Ph: (321) 722-5200 | Sally's House 2061 Harbor Ave Ne Palm Bay FL 32905-3114 Ph: (321) 722-5200 |
| NPI Number | 1689059719 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 07/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689059719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1805AS155311 (Florida) | Primary |
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