Healthcare Provider Details

I. General information

NPI: 1619399417
Provider Name (Legal Business Name): HEAL, ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8470 ENTERPRISE CIR
LAKEWOOD RANCH FL
34202-4102
US

IV. Provider business mailing address

8470 ENTERPRISE CIR
LAKEWOOD RANCH FL
34202-4102
US

V. Phone/Fax

Practice location:
  • Phone: 941-462-4807
  • Fax:
Mailing address:
  • Phone: 941-462-4807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number7240
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberSW 13170
License Number StateFL

VIII. Authorized Official

Name: MARGARET YOUNG
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 941-462-4807