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General NPI Number Information
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NPI Number | 1548618234
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Entity Type | Organization
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Legal Business Name | COMPLETE PRACTITIONER CARE, LLC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 4027 CITROEN DR
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City | SEBRING
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State | FL
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Zip | 33872-3027
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Country | US
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Telephone | 863-202-3580
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Fax |
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Provider Business Mailing Address
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Address Line | 4027 CITROEN DR
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City | SEBRING
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State | FL
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Zip | 33872-3027
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Country | US
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Telephone | 863-202-3580
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER - PROVIDER/MGR
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Name | MICHAEL GEORGE CLEVELEY
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Credential | ARNP
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Telephone | 863-202-3580
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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