# MANATEE CARE P.A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003699646
- **Authorized official:** DAMAYANTI DIPAYANA (DIRECTOR)
- **Authorized official phone:** (646) 945-8900

## Contact information

- **Practice address:** 4925 S BROADWAY AVE UNIT 8181, WICHITA, KS 67216-3716
- **Practice address phone:** (213) 558-4348
- **Mailing address:** 3355 HUDSON ST UNIT 7517, DENVER, CO 80207-7523
- **Mailing address phone:** (213) 558-4348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TF0000X | Family Psychologist | — | NULL | Yes |
| 103TF0000X | Family Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2023
- **Last updated:** 01/17/2024