| Bjl2, Inc | |
|
1910 W Pickett Ct Hernando FL 34442-3244 | |
| (352) 697-5942 | |
| Not Available |
| Full Name | Bjl2, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1910 W Pickett Ct, Hernando, Florida |
| Authorized Official Name and Position | Jean Marie Lichtenthal (MANAGER) |
| Authorized Official Contact | 3526975943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bjl2, Inc 1910 W Pickett Ct Hernando FL 34442-3244 Ph: (352) 697-5942 | Bjl2, Inc 1910 W Pickett Ct Hernando FL 34442-3244 Ph: (352) 697-5942 |
| NPI Number | 1821858986 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 03/19/2024 |
| Certification Date | 03/19/2024 |
| Medicare PECOS PAC ID | 8426593427 |
|---|---|
| Medicare Enrollment ID | O20240715002379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821858986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robert Lichtenthal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639553811 PECOS PAC ID: 9335684331 Enrollment ID: I20240715002836 |
Source Route Products, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3795 E Parsons Point Rd, Box 1047, Hernando, FL 34442 Phone: 202-480-9234 |