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1346825015
LBM PMHNP
ST AUGUSTINE, FL
NPI
1346825015
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Entity Type
Organization
Authorized Contact
LATISHSA BLANCHARD
President
402-813-3716
Organization Subpart ?
No
Primary Taxonomy
261QM0850X Clinic/Center, Adult Mental Health
Enumeration Date
2021-03-15
Last Update Date
2021-03-15
Business Address
LBM PMHNP
109 CEJA WAY
ST AUGUSTINE, FL 32095-4852
Phone number: 402-813-3716
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Mailing Address
LBM PMHNP
109 CEJA WAY
ST AUGUSTINE, FL 32095-4852
Phone number: 402-813-3716
Copy
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