Organization
CHARIS CENTER
Active
Organization
CHARIS CENTER
Active
Other names
Charis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE STOLL (PRESIDENT/BOARD OF DIRECTORS)
(941) 378-1549
Entity
Organization
Contact information
Practice address
4041 BAHIA VISTA ST., SARASOTA, FL 34233
(941) 378-1549
(940) 342-1781
Mailing address
4041 BAHIA VISTA STREET, SARASOTA, FL 34232
(941) 378-1549
(941) 342-1781
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
FL
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26181400
CHARISCENTER AETNA GROUP#
FL
01
—
26181400
AETNA GROUP
—
Enumeration date
08/05/2006
Last updated
04/27/2015
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