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General NPI Number Information
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NPI Number | 1376328195
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Entity Type | Organization
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Legal Business Name | MIND-NEURO AND BEHAVIORAL CARE LLC
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 6238 SAND HILLS CIR
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City | LAKE WORTH
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State | FL
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Zip | 33463-8226
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Country | US
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Telephone | 407-272-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 6238 SAND HILLS CIR
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City | LAKE WORTH
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State | FL
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Zip | 33463-8226
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Country | US
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Telephone | 407-272-0201
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROLANDE J BELLEGARDE
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Credential | APRN
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Telephone | 407-272-0201
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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 |
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License Number State |
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