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General NPI Number Information
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NPI Number | 1467931592
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC CENTER FOR HOPE
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 4631 WINDWARD COVE LN
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City | WELLINGTON
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State | FL
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Zip | 33449-7401
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Country | US
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Telephone | 156-120-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 4631 WINDWARD COVE LN
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City | WELLINGTON
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State | FL
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Zip | 33449-7401
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Country | US
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Telephone | 561-206-4073
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | MRS. ALEXIA MCLEOD
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Credential | LCSW
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Telephone | 561-206-4073
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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 | SW11097
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License Number State | FL
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