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NPI 1992274161

NPI 1992274161 : SUNCOAST FAMILY GUIDANCE CENTER : SARASOTA, FL

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General NPI Number Information
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    NPI Number           |    1992274161
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    Entity Type          |    Organization 
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    Legal Business Name  |    SUNCOAST FAMILY GUIDANCE CENTER 
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Dates
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    Enumeration Date     |    11/17/2018
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    Last Update Date     |    11/19/2018
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Provider Practice Location Address
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    Address Line         |    5624 PALMER BLVD 
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    City                 |    SARASOTA
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    State                |    FL
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    Zip                  |    34232-2736
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    Country              |    US
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    Telephone            |    941-586-4561
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1184 FRASER PINE BLVD 
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    City                 |    SARASOTA
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    State                |    FL
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    Zip                  |    34240-1412
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    Country              |    US
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    Telephone            |    941-586-4561
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. PHYLLIS HANNAH BOWERS PARKER 
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    Credential           |    PH.D
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    Telephone            |    941-586-4561
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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       |    
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    License Number State |    
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