The Wave Of Brooksville, Llc | |
7300 Grove Rd Brooksville FL 34613-6012 | |
(352) 442-2643 | |
Not Available |
Full Name | The Wave Of Brooksville, Llc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 7300 Grove Rd, Brooksville, Florida |
Authorized Official Name and Position | Andre Genao (EXECUTIVE DIRECTOR - COMPLIANCE) |
Authorized Official Contact | 3524422643 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
The Wave Of Brooksville, Llc 2120 Range Rd Clearwater FL 33765-2125 Ph: (352) 442-2643 | The Wave Of Brooksville, Llc 7300 Grove Rd Brooksville FL 34613-6012 Ph: (352) 442-2643 |
NPI Number | 1568050565 |
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Provider Enumeration Date | 01/05/2021 |
Last Update Date | 01/05/2021 |
Certification Date | 01/05/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568050565 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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