Organization
GAINESVILLE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY GREEN MFT (OWNDER)
(352) 448-9120
Entity
Organization
Contact information
Practice address
1521 NW 34TH ST, GAINESVILLE, FL 32605-5033
(352) 448-9120
Mailing address
18015 SW 95TH AVE, ARCHER, FL 32618-3407
(352) 448-9120
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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