MEDICARE: POSITIVE SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	SW9585	FL

General Provider Information

NPI Number	:	1235679499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	10024 PARLEY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-5403
Country	:	US
Telephone Number	:	813-785-9259
Fax Number	:

Provider Business Practice Location Address
First Line	:	10024 PARLEY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-5403
Country	:	US
Telephone Number	:	813-785-9259
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CARRIE L FREY-DAVIS
Credential	:	LCSW
Telephone Number	:	813-785-9259

Provider Enumeration Date	:	03/07/2017
Last Update Date	:	04/28/2017

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