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General NPI Number Information
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NPI Number | 1457542359
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH COMMUNITY CENTERS, INC.
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 240B S TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34237-6334
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Country | US
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Telephone | 941-953-3477
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Fax | 941-954-4541
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Provider Business Mailing Address
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Address Line | 240B S TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34237-6334
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Country | US
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Telephone | 941-953-3477
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Fax | 941-954-4541
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CAROLYN A EAGEN
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Credential |
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Telephone | 941-953-3477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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