Organization
MANATEE GLENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA WHITE CLAVEY (OUTPATIENT THERAPIST)
(941) 782-4299
Entity
Organization
Contact information
Practice address
379 6TH AVE W, BRADENTON, FL 34205-8820
(941) 782-4299
Mailing address
379 6TH AVE W, BRADENTON, FL 34205-8820
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
MH5954
FL
Other
Enumeration date
12/06/2005
Last updated
08/22/2020
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