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NPI Code Detail

MEDICARE: UNLIMITED POTENTIALS FOR LIFE

MEDICARE: UNLIMITED POTENTIALS FOR LIFE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH7312FL

General Provider Information

NPI Number : 1992976708
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNLIMITED POTENTIALS FOR LIFE
Provider Business Mailing Address
First Line : 612 DATE PALM DR
Second Line :
City : LAKE PARK
State : FL
Zip : 33403-3227
Country : US
Telephone Number : 561-841-3990
Fax Number : 561-863-0087
Provider Business Practice Location Address
First Line : 721 US HIGHWAY 1
Second Line : STE 108
City : NORTH PALM BEACH
State : FL
Zip : 33408-4512
Country : US
Telephone Number : 561-841-3990
Fax Number : 561-863-0087
Authorized Official
Title or Position : CEO
Name : KAFFIE CLARK
Credential : LMHC,
Telephone Number : 561-841-3990
Provider Enumeration Date : 03/19/2008
Last Update Date : 03/27/2008

Similar Medicare Providers

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1023092087 — MR. JOHN S LEDAKIS DDS
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1528136025 — JOAN LESLIE MARINEAU LMHC
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Directions to “UNLIMITED POTENTIALS FOR LIFE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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