Organization
PARENT SUPPORT, LLC
Active
Other names
CARES Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKKI-ANN S. SAMUEL M.D. (MEDICAL DIRECTOR)
(947) 282-4222
Entity
Organization
Contact information
Practice address
1442 BRUSH ST, SUITE 200, DETROIT, MI 48226-2285
(947) 282-4222
(407) 930-4830
Mailing address
3218 EAGLE WATCH DR, KISSIMMEE, FL 34746-3138
(407) 901-4000
(407) 930-4830
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
09/11/2016
Last updated
09/11/2016
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