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General NPI Number Information
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NPI Number | 1740478627
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Entity Type | Organization
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Legal Business Name | SEMINOLE COMMUNITY MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 351 S BAY AVE
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City | SANFORD
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State | FL
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Zip | 32771-2140
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Country | US
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Telephone | 407-321-3154
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Fax |
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Provider Business Mailing Address
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Address Line | 237 FERNWOOD BLVD
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City | FERN PARK
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State | FL
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Zip | 32730-2116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESIDENTIAL COUNSELOR
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Name | RAYNETTE LAMAR
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Credential |
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Telephone | 407-321-8908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 323P00000X
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License Number State | FL
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