institution
Lbm Pmhnp
Adult Mental Health Clinic/Center in St Augustine, Florida
NPI 1346825015

Lbm Pmhnp is an Adult Mental Health Clinic/Center based in St Augustine, FL and is specialized in Adult Mental Health. Lbm Pmhnp practices in St Augustine, FL. The NPI Number for Lbm Pmhnp is 1346825015 and holds a License No. (Florida).

The current practice location address for Lbm Pmhnp is 109 Ceja Way, St Augustine, FL and can be reached out via phone at 402-813-3716.

Location: 109 Ceja Way, St Augustine, FL, 32095-4852
institution
Provider Profile Details
NPI Number
1346825015
Provider Name
Lbm Pmhnp
Credential
Provider Entity Type
Organization
Address
109 Ceja Way, St Augustine, FL, 32095-4852
Phone Number
402-813-3716
Fax Number
Provider Enumeration Date
03/15/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B452-533-77-542-0 01 FL FL DRIVERS LICENSE
B452-533-77-542-0 01 FL DRIVERS LICENSE
institution
Provider Business Practice Location Address Details
Address
109 Ceja Way
City
State
Zip
32095-4852
Phone Number
402-813-3716
Fax Number
person
Provider Business Mailing Address Details
Address
109 Ceja Way
City
State
Zip
32095-4852
Phone Number
402-813-3716
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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