Organization
PARENT SUPPORT, LLC
Active
Other names
Heart Transformation Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKKI-ANN S. SAMUEL M.D. (MEDICAL DIRECTOR)
(407) 901-4000
Entity
Organization
Contact information
Practice address
389 SAND RIDGE DR, DAVENPORT, FL 33896-4717
(407) 901-4000
(407) 930-4830
Mailing address
389 SAND RIDGE DR, DAVENPORT, FL 33896-4717
(407) 901-4000
(407) 930-4830
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CARF ACCREDITED
FL
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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