| Soulstice Therapeutic Solutions, Llc | |
|
901 W Main St Ste 121 Wauchula FL 33873-2532 | |
| (863) 773-6573 | |
| Not Available |
| Full Name | Soulstice Therapeutic Solutions, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 901 W Main St Ste 121, Wauchula, Florida |
| Authorized Official Name and Position | Micah S. Hendrickson (OWNER) |
| Authorized Official Contact | 8637736573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulstice Therapeutic Solutions, Llc Po Box 577 Wauchula FL 33873-0577 Ph: (863) 773-6573 | Soulstice Therapeutic Solutions, Llc 901 W Main St Ste 121 Wauchula FL 33873-2532 Ph: (863) 773-6573 |
| NPI Number | 1821545815 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 09/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821545815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MH13683 (Florida) | Primary |
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