Organization
ENHANCED LIFESTYLE SENIOR HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GONZALEZ (OWNER)
(813) 453-6179
Entity
Organization
Contact information
Practice address
2125 HARDEN BLVD, LAKELAND, FL 33803-5918
(863) 222-4060
Mailing address
2125 HARDEN BLVD, LAKELAND, FL 33803-5918
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/25/2022
Last updated
05/06/2022
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