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General NPI Number Information
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NPI Number | 1881405249
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Entity Type | Organization
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Legal Business Name | ABT WELLNESS AND RETREATS LLC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1320 NE 28TH AVE
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City | GAINESVILLE
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State | FL
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Zip | 32609-3115
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Country | US
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Telephone | 904-290-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 NE 28TH AVE
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City | GAINESVILLE
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State | FL
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Zip | 32609-3115
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Country | US
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Telephone | 305-498-0088
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | ARZELLA HAWTHORNE-LOUIDOR
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Credential | LMHC, LPC
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Telephone | 305-498-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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