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Organization
PARENT CHILD CENTER
Active
Organization
PARENT CHILD CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANYA G GILMORE BACHELOR OF ARTS (TARGETED CASE MANAGER)
(561) 841-3500
Entity
Organization
Contact information
Practice address
2001 W BLUE HERON BLVD, RIVIERA BEACH, FL 33404-5003
(561) 841-3500
(561) 841-3555
Mailing address
2001 W BLUE HERON BLVD, RIVIERA BEACH, FL 33404-5003
(561) 841-3500
(561) 841-3555
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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