Organization
SUNSHINE BEHAVIOR MOMENTUM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIBLENA WALLACE (ADMINISTRATOR)
(813) 530-4428
Entity
Organization
Contact information
Practice address
711 PARSONS POINTE ST, SEFFNER, FL 33584-7804
(813) 530-4428
Mailing address
711 PARSONS POINTE ST, SEFFNER, FL 33584-7804
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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