NPI | 1104572551 |
---|---|
Doing Business As | PEACE RIVER CENTER |
Entity Type | Organization |
Authorized Contact | JO DECK Credentialing Specialist 863-519-0575 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-02-24 |
Last Update Date | 2023-02-01 |