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General NPI Number Information
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NPI Number | 1972809937
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Entity Type | Organization
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Legal Business Name | ABIDE IN HIM, INC
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 975 W JEFFERSON ST
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City | BROOKSVILLE
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State | FL
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Zip | 34601-2427
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Country | US
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Telephone | 352-796-6557
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Fax | 352-796-6557
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Provider Business Mailing Address
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Address Line | PO BOX 10734
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City | BROOKSVILLE
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State | FL
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Zip | 34603-0734
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Country | US
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Telephone | 352-796-6557
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Fax | 352-796-6557
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RITA R RUDNY
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Credential | LMHC
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Telephone | 352-796-6557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MH1988
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License Number State | FL
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