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General NPI Number Information
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NPI Number | 1235570284
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Entity Type | Organization
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Legal Business Name | ALLIANCE MENTAL HEALTH GROUP, LLC
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Dates
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Enumeration Date | 07/07/2013
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Last Update Date | 07/07/2013
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Provider Practice Location Address
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Address Line | 15120 COUNTY LINE RD
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City | SPRING HILL
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State | FL
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Zip | 34610-6725
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Country | US
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Telephone | 727-480-7504
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Fax | 727-755-0315
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Provider Business Mailing Address
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Address Line | 13404 WHITE PLAINS ST
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City | SPRING HILL
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State | FL
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Zip | 34609-6472
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Country | US
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Telephone | 727-480-7504
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Fax | 727-755-0315
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Authorized Official
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Title or Position | CEO
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Name | MS. NANCY AVALONE
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Credential | LMHC
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Telephone | 727-480-7504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MH11264
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License Number State | FL
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