Organization
SUNCOAST MENTAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAELENE REESE (CREDENTIALING COORDINATOR)
(772) 489-4726
Entity
Organization
Contact information
Practice address
1456 OLD DIXIE HWY, VERO BEACH, FL 32960-3773
(772) 564-8616
(772) 299-3757
Mailing address
2222 COLONIAL RD STE 100, FORT PIERCE, FL 34950-5309
(772) 489-4726
(772) 466-5578
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910818103
—
FL
Enumeration date
06/09/2021
Last updated
06/09/2021
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