Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
261QR0401X | B4[14] | Comprehensive Outpatient Rehabilitation Facility | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center |
| NPI Number | 1154629277 |
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| LBN Legal business name | WINTERHAVEN PROFESSIONAL COUNSELING | ||||
| Authorized official | DORIS SMALL - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/14/2011 | ||||
| Last updated | 07/12/2023 - About 3 years ago | ||||
| Identifiers |
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