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Organization

NEUROSCIENCE CENTER

Active
Parent organization
TALLAHASSEE MEMORIAL HEALTHCARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
TALLAHASSEE MEMORIAL HEALTHCARE
Authorized official
JUDY SHIPMAN LCSW (COORDINATOR)
(850) 431-5001
Entity
Organization

Contact information

Practice address
1401 CENTERVILLE RD, SUITE 504, TALLAHASSEE, FL 32308-4647
(850) 431-5001
(850) 431-6101
Mailing address
1401 CENTERVILLE RD, SUITE 504, TALLAHASSEE, FL 32308-4647
(850) 431-5001
(850) 431-6101

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24766O
MEDICARE GROUP NUMBER
Enumeration date
07/08/2008
Last updated
07/08/2008
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