Mangrove Wellness Center,Inc

LBN: Mangrove Wellness Center,Inc
Mangrove Wellness Center,Inc is an health care organization with primary practice located at 1515 Tamiami Trail S. Suite 2, Venice FL 34285. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Mangrove Wellness Center,Inc can be contacted via phone (941) 822-5620, or through Reidsema, Lisa via phone (941) 822-5620.

Contact Information

Primary practice address
1515 Tamiami Trail S. Suite 2 Venice FL 34285
Phone: (941) 822-5620
Fax: (855) 239-0365
Website:
Map and Directions
Authorized official contact:
Name: Reidsema, Lisa LMHC
Phone: (941) 822-5620

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH12785 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X PY5867 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X MH12785 Florida
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY5867 Florida

Profile Details

NPI number 1285987453
LBN Legal business name Mangrove Wellness Center,Inc
DBA Doing business as
Authorized official Reidsema, Lisa LMHC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2012
Last updated Oct 13th, 2014 - about 12 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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