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General NPI Number Information
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NPI Number | 1457921306
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH RESOURCE CENTER INC
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 626 LAKEVIEW RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33756-3359
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Country | US
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Telephone | 727-449-8331
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Fax | 727-290-3783
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Provider Business Mailing Address
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Address Line | PO BOX 19249
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City | JACKSONVILLE
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State | FL
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Zip | 32245-9249
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Country | US
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Telephone | 904-743-1883
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Fax | 904-743-5309
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ROBERT SOMMERS
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Credential | PH.D
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Telephone | 904-743-1883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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