Vince Carter Sanctuary | |
301 Justice Ln Bunnell FL 32110-4487 | |
(800) 478-0331 | |
(386) 236-3178 |
Full Name | Vince Carter Sanctuary |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 301 Justice Ln, Bunnell, Florida |
Authorized Official Name and Position | Ivan A Cosimi (CEO/PRESIDENT) |
Authorized Official Contact | 3862361811 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Vince Carter Sanctuary 150 Magnolia Ave Daytona Beach FL 32114-4304 Ph: (386) 236-3200 | Vince Carter Sanctuary 301 Justice Ln Bunnell FL 32110-4487 Ph: (800) 478-0331 |
NPI Number | 1487955977 |
---|---|
Provider Enumeration Date | 11/15/2010 |
Last Update Date | 07/29/2021 |
Certification Date | 07/29/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487955977 | NPI | - | NPPES |
060311210 | Medicaid | FL |
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