Healthcare Provider Details

I. General information

NPI: 1104403559
Provider Name (Legal Business Name): ARCH MENTAL HEALTH & HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13083 CURRY DR
SPRING HILL FL
34609-0932
US

IV. Provider business mailing address

13083 CURRY DR
SPRING HILL FL
34609-0932
US

V. Phone/Fax

Practice location:
  • Phone: 352-442-2657
  • Fax:
Mailing address:
  • Phone: 352-442-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANNY GUNADASA
Title or Position: ADMIN
Credential:
Phone: 352-442-2657