Organization
ICM ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHRYN DIANNE CARAVELLA CAC, NCAC1, BRI-1 (CEO)
(727) 392-5600
Entity
Organization
Contact information
Practice address
900 CARILLON PKWY, SUITE 301, SAINT PETERSBURG, FL 33716-1115
(727) 392-5600
Mailing address
15454 1ST ST E, MADEIRA BEACH, FL 33708-1803
(727) 392-5600
(727) 499-7517
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4013A
FL
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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