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Organization

THE GROVE COUNSELING CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY A BIRCH LMHC (PRESIDENT)
(407) 327-1765
Entity
Organization

Contact information

Practice address
111 W MAGNOLIA AVE, LONGWOOD, FL 32750-4130
(407) 327-1765
(407) 339-2129
Mailing address
111 W MAGNOLIA AVE, LONGWOOD, FL 32750-4130
(407) 327-1765
(407) 339-2129

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0295965
FL
01
122945
VALUE OPTIONS #
FL
01
208983
HARMONY HEALTH
FL
01
216457
AMERIGROUP #
FL
01
331964
MHN, INC.
FL
01
44248
CIGNA PROVIDER #
FL
01
S2A
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/04/2006
Last updated
01/07/2009
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