<Unavail>

LBN: Amy C. Ellis
<Unavail> is an health care organization with primary practice located at 124 E Miracle Strip Pkwy Ste 602 , Mary Esther FL 32569-1991. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Amy C. Ellis can be contacted via phone (850) 243-8529, or through Ellis, Amy via phone (850) 243-7035.

Contact Information

Primary practice address
124 E Miracle Strip Pkwy Ste 602 Mary Esther FL 32569-1991
Phone: (850) 243-8529
Fax: (850) 243-8529
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Amy
Phone: (850) 243-7035

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH6475 Florida

Profile Details

NPI number 1841714458
LBN Legal business name Amy C. Ellis
DBA Doing business as <Unavail>
Authorized official Ellis, Amy
Entity Organization
Organization subpart 1 No
Enumeration date Jul 26th, 2017
Last updated Jun 16th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841714458 NPPES
Florida Other MH6475 STATE LICENSE

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