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General NPI Number Information
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NPI Number | 1578993960
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Entity Type | Organization
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Legal Business Name | MEDWARDS COMMUNITY HEALTH
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 1144 SE 44TH AVE
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City | OCALA
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State | FL
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Zip | 34471-3230
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Country | US
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Telephone | 352-727-1877
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 SE 44TH AVE
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City | OCALA
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State | FL
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Zip | 34471-3230
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Country | US
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Telephone | 352-727-1877
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSLOR
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Name | MERSHA NATASHA EDWARDS
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Credential | MHC
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Telephone | 352-727-1877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | LMHI 9956
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License Number State | FL
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