Organization
AFFINITY WELLNESS CORPORATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN LAKE (CEO)
(608) 732-1007
Entity
Organization
Contact information
Practice address
2211 S HIGHWAY 77, SUITE 101-102, LYNN HAVEN, FL 32444-4640
(850) 896-1818
(850) 722-8782
Mailing address
2211 S HIGHWAY 77, SUITE 101-102, LYNN HAVEN, FL 32444-4640
(850) 896-1818
(850) 722-8782
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
FL
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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