| Peace River Center For Personal Development Inc | |
|
1255 Golfview Ave Bartow FL 33830-6736 | |
| (863) 519-0575 | |
| (863) 582-9251 |
| Full Name | Peace River Center For Personal Development Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1255 Golfview Ave, Bartow, Florida |
| Authorized Official Name and Position | Jo Deck (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8635190575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace River Center For Personal Development Inc Po Box 1559 Bartow FL 33831-1559 Ph: (863) 519-0575 | Peace River Center For Personal Development Inc 1255 Golfview Ave Bartow FL 33830-6736 Ph: (863) 519-0575 |
| NPI Number | 1104572551 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104572551 | NPI | - | NPPES |
| 060310438 | Medicaid | FL |
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