# CAMPBELL'S MULTI SERVICE OUTREACH CENTER

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

## Provider details

- **NPI number:** 1831837616
- **Authorized official:** MS. LATANGRA MCINTOSH MCINTOSH PMHNP (OWNER)
- **Authorized official phone:** (863) 860-4516

## Contact information

- **Practice address:** 211 DORIS DR, LAKELAND, FL 33813-1006
- **Practice address phone:** (863) 860-4516
- **Practice address fax:** (863) 837-4413
- **Mailing address:** 715 HEMENWAY DR NE, WINTER HAVEN, FL 33881-2700
- **Mailing address phone:** (863) 860-4516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2022
- **Last updated:** 05/23/2022