Organization
VINTAGE PSYCHIATRIC CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADA PARKE-GASKIN (FOUNDER)
(469) 905-0020
Entity
Organization
Contact information
Practice address
7163 HIAWASSEE OAK DR, ORLANDO, FL 32818-8357
(407) 237-0399
Mailing address
7163 HIAWASSEE OAK DR, ORLANDO, FL 32818-8357
(407) 237-0399
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
02/25/2026
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