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Organization
REFRESH CANOPY COVE INC.
Active
Organization
REFRESH CANOPY COVE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH PESCE (SECRETARY)
(904) 605-4986
Entity
Organization
Contact information
Practice address
13305 MAHAN DR, TALLAHASSEE, FL 32309
(850) 893-8800
Mailing address
13305 MAHAN DR, TALLAHASSEE, FL 32309-8698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/01/2018
Last updated
03/30/2023
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