| Peace And Mental Crossing, Llc | |
|
3319 Russett Dr Tampa FL 33618-1307 | |
| (813) 509-1315 | |
| Not Available |
| Full Name | Peace And Mental Crossing, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3319 Russett Dr, Tampa, Florida |
| Authorized Official Name and Position | Vaniece Johnson (OWNER) |
| Authorized Official Contact | 8135091315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace And Mental Crossing, Llc 3319 Russett Dr Tampa FL 33618-1307 Ph: () - | Peace And Mental Crossing, Llc 3319 Russett Dr Tampa FL 33618-1307 Ph: (813) 509-1315 |
| NPI Number | 1437843299 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Medicare PECOS PAC ID | 8729433420 |
|---|---|
| Medicare Enrollment ID | O20231016003047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437843299 | NPI | - | NPPES |
| Provider Name | Vaniece Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467062109 PECOS PAC ID: 1557723244 Enrollment ID: I20230811001726 |
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