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General NPI Number Information
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NPI Number | 1790597201
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Entity Type | Organization
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Legal Business Name | BLUE WATER THE ISLAND'S FAMILY MENTAL HEALTH CENTER LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 300 SOUTHARD ST STE 102
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City | KEY WEST
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State | FL
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Zip | 33040-8401
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Country | US
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Telephone | 786-982-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 302 FLEMING ST
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City | KEY WEST
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State | FL
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Zip | 33040-8393
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Country | US
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Telephone | 786-982-0459
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ERIN SHEEHAN
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Credential |
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Telephone | 504-352-4896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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