| Fsba,inc | |
|
19802 Old Bellamy Rd Alachua FL 32615-3867 | |
| (352) 278-1920 | |
| Not Available |
| Full Name | Fsba,inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 19802 Old Bellamy Rd, Alachua, Florida |
| Authorized Official Name and Position | Susan Deborah Cliett (CEO) |
| Authorized Official Contact | 3522781920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fsba,inc 19802 Old Bellamy Rd Alachua FL 32615-3867 Ph: (352) 278-1920 | Fsba,inc 19802 Old Bellamy Rd Alachua FL 32615-3867 Ph: (352) 278-1920 |
| NPI Number | 1427508100 |
|---|---|
| Provider Enumeration Date | 10/06/2016 |
| Last Update Date | 10/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427508100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH2814 (Florida) | Primary |
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