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General NPI Number Information
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NPI Number | 1508141110
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Entity Type | Organization
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Legal Business Name | ASHLEE COMEAU, INC.
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 1300 CORPORATE CENTER WAY 105C
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City | WELLINGTON
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State | FL
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Zip | 33414-8599
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Country | US
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Telephone | 561-656-1006
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Fax | 561-656-1006
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Provider Business Mailing Address
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Address Line | 8728 WOODGROVE HARBOR LN
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-4840
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Country | US
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Telephone | 561-656-1006
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Fax | 561-656-1006
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEE COMEAU
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Credential |
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Telephone | 561-656-1006
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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 | MH10878
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License Number State | FL
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