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General NPI Number Information
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NPI Number | 1316332992
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Entity Type | Organization
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Legal Business Name | COMMUNITY BEHAVIORAL HEALTH APPROACH
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 2117 SW HIGHWAY 484
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City | OCALA
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State | FL
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Zip | 34473-7949
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Country | US
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Telephone | 352-873-6332
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Fax |
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Provider Business Mailing Address
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Address Line | 2117 SW HIGHWAY 484
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City | OCALA
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State | FL
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Zip | 34473-7949
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Country | US
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Telephone | 352-873-6332
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN COOPER
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Credential |
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Telephone | 352-873-6332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9529
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License Number State | FL
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