Organization · NPI-2

Ag Therapy Clinic INC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Kissimmee, FL

NPI number1497304398
StatusActive
Last updated in NPPESDec 3, 2019

Details

NPI
1497304398
Entity type
Organization (NPI-2)
Legal business name
Ag Therapy Clinic INC
Organization subpart
No
Enumeration date
Sep 4, 2019
Last updated
Dec 3, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
103K00000X Behavior Analyst––
101YM0800X Counselor, Mental Health––
2084P0800X Psychiatry & Neurology, Psychiatry––

Practice location

2910 Conner Ln
Kissimmee, FL 34741-7722

Phone 305-498-9760

Mailing address

2910 Conner Ln
Kissimmee, FL 34741-7722

Phone 305-498-9760

Other practice locations

2910 Conner Ln
Kissimmee, FL 34741-7722

Phone 305-498-9760

Authorized official

Yvonne Rodriguez
Chief Financial Officer
3054989760

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, Mental Health (Including Community Mental Health Center) providers in Kissimmee, FL