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Organization
CENTER OF LIFE HEALTH, INC.
Active
Organization
CENTER OF LIFE HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN SUE FULLER L.M.H.C. (DIRECTOR)
(772) 220-4556
Entity
Organization
Contact information
Practice address
322 SW OCEAN BLVD, STUART, FL 34994
(772) 220-4556
(772) 220-2214
Mailing address
322 SW OCEAN BLVD, STUART, FL 34994
(772) 220-4556
(772) 220-2214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH3692
FL
101YP2500X
Professional Counselor
MH3692
FL
Other
Enumeration date
11/14/2006
Last updated
10/06/2010
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