Organization
FOR THE COMMUNITY FLORIDA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENETTA TANICA SLONE (OWNER)
(623) 628-4079
Entity
Organization
Contact information
Practice address
627 WILLIAMS ST, MELBOURNE, FL 32901-6053
(623) 628-4079
Mailing address
8721 W WILSHIRE DR, PHOENIX, AZ 85037-3605
(623) 628-4079
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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