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Organization

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Organization subpart
No

Provider details

NPI number
Authorized official
LYNN TRIMBLE (PRESIDENT)
(561) 745-1779
Entity
Organization

Contact information

Practice address
17772 BRIDLE LN, JUPITER, FL 33478-4718
(561) 745-1779
(561) 745-1780
Mailing address
17772 BRIDLE LN, JUPITER, FL 33478-4718
(561) 745-1779
(561) 745-1780

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH12298
FL
1041C0700X
Clinical Social Worker
Primary
SW10878
FL

Other

Enumeration date
12/21/2013
Last updated
02/07/2014
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