Organization
PRESCRIBED PEDIATRIC EXTENDED CARE INC.
Active
Other names
Pediatric Health Choice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE RHIANNON WACK (BEHAVIOR SPECIALIST)
(727) 804-4748
Entity
Organization
Contact information
Practice address
4144 N ARMENIA AVE STE 350, TAMPA, FL 33607-6434
(813) 872-8521
(813) 200-3707
Mailing address
4144 N ARMENIA AVE STE 350, TAMPA, FL 33607-6434
(813) 872-8521
(813) 200-3707
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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