| Therapeutic Life Services, Inc | |
|
16071 Micelli Dr Winter Garden FL 34787-1821 | |
| (305) 607-2896 | |
| Not Available |
| Full Name | Therapeutic Life Services, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 16071 Micelli Dr, Winter Garden, Florida |
| Authorized Official Name and Position | David Gomez (MR.) |
| Authorized Official Contact | 3056072896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Life Services, Inc 7830 Nw 161st Ter Miami Lakes FL 33016-6677 Ph: () - | Therapeutic Life Services, Inc 16071 Micelli Dr Winter Garden FL 34787-1821 Ph: (305) 607-2896 |
| NPI Number | 1225641616 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 11/18/2022 |
| Certification Date | 11/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225641616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
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