| Progressive Mental Wellness Llc | |
|
108 Highland St Orange City FL 32763 | |
| (386) 837-4387 | |
| Not Available |
| Full Name | Progressive Mental Wellness Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 108 Highland St, Orange City, Florida |
| Authorized Official Name and Position | Christopher Gaitor (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 3868374387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Mental Wellness Llc 108 Highland St Orange City FL 32763-7017 Ph: (386) 837-4387 | Progressive Mental Wellness Llc 108 Highland St Orange City FL 32763 Ph: (386) 837-4387 |
| NPI Number | 1518772847 |
|---|---|
| Provider Enumeration Date | 02/12/2025 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/07/2025 |
| Medicare PECOS PAC ID | 1153844238 |
|---|---|
| Medicare Enrollment ID | O20250329000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518772847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christopher M Gaitor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821700980 PECOS PAC ID: 4385000348 Enrollment ID: I20230517000564 |
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