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General NPI Number Information
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NPI Number | 1194239327
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Entity Type | Organization
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Legal Business Name | ONE PLACE PSYCHIATRIC CARE LLC
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1500 N UNIVERSITY DR STE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071
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Country | US
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Telephone | 954-350-0747
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Fax | 954-350-0499
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Provider Business Mailing Address
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Address Line | 1500 N UNIVERSITY DR STE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6072
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Country | US
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Telephone | 954-350-0747
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MARIE ROSE SAMUELA JASMIN
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Credential | ARNP
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Telephone | 754-214-9598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9294753
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License Number State | FL
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