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Organization
GROWTH AND RECOVERY CENTER
Active
Organization
GROWTH AND RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE BASAK RD,LD (REGISTERED DIETITIAN)
(727) 342-3195
Entity
Organization
Contact information
Practice address
7747 MITCHELL BLVD STE B, TRINITY, FL 34655-4725
(727) 342-3915
Mailing address
7747 MITCHELL BLVD STE B, TRINITY, FL 34655-4725
(727) 342-3915
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7286
FL
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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