| Suncoast Mental Health Center, Inc. | |
|
2222 Colonial Rd Ste 100 Fort Pierce FL 34950-5309 | |
| (772) 489-4726 | |
| (772) 466-5578 |
| Full Name | Suncoast Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2222 Colonial Rd Ste 100, Fort Pierce, Florida |
| Authorized Official Name and Position | Michaelene Reese (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7724894726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suncoast Mental Health Center, Inc. 2222 Colonial Rd Ste 100 Fort Pierce FL 34950-5309 Ph: (772) 489-4726 | Suncoast Mental Health Center, Inc. 2222 Colonial Rd Ste 100 Fort Pierce FL 34950-5309 Ph: (772) 489-4726 |
| NPI Number | 1225605058 |
|---|---|
| Provider Enumeration Date | 06/09/2021 |
| Last Update Date | 06/09/2021 |
| Certification Date | 05/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225605058 | NPI | - | NPPES |
| 910818100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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