| Agency Provider Services For Independence Llc | |
|
1418 Norman St Ne Unit#1 Palm Bay FL 32907-2267 | |
| (321) 890-7014 | |
| (321) 722-3760 |
| Full Name | Agency Provider Services For Independence Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1418 Norman St Ne, Palm Bay, Florida |
| Authorized Official Name and Position | Deannalynn Cenkner (PRESIDENT/OWNER) |
| Authorized Official Contact | 3218907014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agency Provider Services For Independence Llc Po Box 101369 Palm Bay FL 32910-1369 Ph: (321) 890-7014 | Agency Provider Services For Independence Llc 1418 Norman St Ne Unit#1 Palm Bay FL 32907-2267 Ph: (321) 890-7014 |
| NPI Number | 1891051132 |
|---|---|
| Provider Enumeration Date | 04/11/2012 |
| Last Update Date | 04/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891051132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | L11000062706 (Florida) | Primary |
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