Rose Souverain

NPI #1073990982 in Ocoee, Florida

Provider Information

NPI Number: 1073990982
Entity Type: Individual
Name: Rose Souverain
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Apr 29, 2015
Last Updated: Apr 29, 2015

Practice Location

Address: 404 TRANQUILLE OAKS DR
City: Ocoee
State: Florida
ZIP Code: 34761-1402
Phone: (321) 460-4138

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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