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Organization

SAGE MENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA LILES APRN (OWNER)
(850) 502-3090
Entity
Organization

Contact information

Practice address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
(850) 290-7331
Mailing address
PO BOX 4418, FORT WALTON BEACH, FL 32549-4418
(850) 502-3090

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/19/2022
Last updated
06/04/2022
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