Organization
BOSS WELLNESS, LLC
Active
Other names
Shantala Boss, LMHC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTALA M BOSS LMHC (OWNER)
(407) 308-0122
Entity
Organization
Contact information
Practice address
3551 W LAKE MARY BLVD STE 208, LAKE MARY, FL 32746-3460
(407) 308-0122
(407) 264-6348
Mailing address
1255 SAINT ALBANS LOOP, LAKE MARY, FL 32746-1979
(407) 308-0122
(407) 264-6348
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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