MEDICARE: POSITIVE SOLUTIONS PCS

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

General Provider Information

NPI Number	:	1629528922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE SOLUTIONS PCS

Provider Business Mailing Address
First Line	:	529 NW PRIMA VISTA BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-8785
Country	:	US
Telephone Number	:	772-528-3828
Fax Number	:

Provider Business Practice Location Address
First Line	:	4949 NW FOXWORTH AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-2302
Country	:	US
Telephone Number	:	772-528-3828
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VIVIAN YOLANDA STONE
Credential	:	LMHC
Telephone Number	:	772-528-3828

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	10/11/2016

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Directions to “POSITIVE SOLUTIONS PCS ” Practice Location

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