Organization
CENTER OF LIFE HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN SUE FULLER L.M.H.C. (DIRECTOR)
(772) 220-4556
Entity
Organization
Contact information
Practice address
322 SW OCEAN BLVD, STUART, FL 34994
(772) 220-4556
(772) 220-2214
Mailing address
322 SW OCEAN BLVD, STUART, FL 34994
(772) 220-4556
(772) 220-2214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH3692
FL
101YP2500X
Professional Counselor
MH3692
FL
Other
Enumeration date
11/14/2006
Last updated
10/06/2010
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