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General NPI Number Information
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NPI Number | 1053203026
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Entity Type | Organization
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Legal Business Name | PACHECO HEALTH VENTURES LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 8025 TEA OLIVE TER
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City | PALMETTO
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State | FL
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Zip | 34221-6657
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Country | US
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Telephone | 727-354-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 TEA OLIVE TER
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City | PALMETTO
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State | FL
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Zip | 34221-6657
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Country | US
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Telephone | 850-716-2420
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA CHEYENNE PACHECO
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Credential | LCSW
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Telephone | 850-716-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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