| Sunserve, Inc | |
|
2312 Wilton Dr 200 Wilton Manors FL 33305-1249 | |
| (954) 764-5150 | |
| (954) 764-5143 |
| Full Name | Sunserve, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2312 Wilton Dr, Wilton Manors, Florida |
| Authorized Official Name and Position | Mark Ketcham (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9547645150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunserve, Inc 2312 Wilton Dr 200 Wilton Manors FL 33305-1249 Ph: (954) 764-5150 | Sunserve, Inc 2312 Wilton Dr 200 Wilton Manors FL 33305-1249 Ph: (954) 764-5150 |
| NPI Number | 1356771968 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 11/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356771968 | NPI | - | NPPES |
| 003155601 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 003155601 (Florida) | Primary |
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