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Organization

PRIMECARE ADVANTAGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY HAY (CEO)
(954) 200-4571
Entity
Organization

Contact information

Practice address
141 NW 35TH CT, OAKLAND PARK, FL 33309-5209
(954) 200-4571
Mailing address
141 NW 35TH CT, OAKLAND PARK, FL 33309-5209
(954) 200-4571

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002207000
FL
Enumeration date
12/30/2011
Last updated
12/30/2011
About Stedi
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  • EDI platform