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General NPI Number Information
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NPI Number | 1962827386
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Entity Type | Organization
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Legal Business Name | GARDENS COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 02/21/2014
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Provider Practice Location Address
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Address Line | 600 SANDTREE DR STE 205
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1538
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Country | US
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Telephone | 561-624-4785
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Fax |
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Provider Business Mailing Address
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Address Line | 600 SANDTREE DR STE 205
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1538
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Country | US
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Telephone | 561-624-4785
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY R MOONEY
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Credential | M.DIV.,M.A.
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Telephone | 561-624-4785
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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 | MH0001966
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License Number State | FL
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