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General NPI Number Information
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NPI Number | 1699043539
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Entity Type | Organization
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Legal Business Name | HIBISCUS CHILDREN'S CENTER
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 664 SW 35TH ST APT 4
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City | PALM CITY
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State | FL
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Zip | 34990-3659
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Country | US
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Telephone | 561-449-5483
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Fax |
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Provider Business Mailing Address
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Address Line | 664 SW 35TH STREET APT 4
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City | PALM CITY
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State | FL
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Zip | 34990
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Country | US
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Telephone | 561-449-5483
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SABRINA LOVELY NOTTINGHAM
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Credential |
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Telephone | 561-449-5483
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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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