Organization
IMPACT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA RICKETTS (DIRECTOR)
(352) 560-7027
Entity
Organization
Contact information
Practice address
110 S APOPKA AVE, INVERNESS, FL 34452-4837
(352) 560-7027
Mailing address
110 S APOPKA AVE, INVERNESS, FL 34452-4837
(352) 560-7027
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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