Alive & Well Corp

NPI #1295245520 in Clermont, Florida

Provider Information

NPI Number: 1295245520
Entity Type: Organization
Organization Name: Alive & Well Corp
Primary Specialty: Counselor - Mental Health
Enumeration Date: Sep 29, 2017
Last Updated: Sep 29, 2017

Practice Location

Address: 10344 VISTA PINES LOOP
City: Clermont
State: Florida
ZIP Code: 34711-9172
Phone: (813) 748-2912

Authorized Official

Name: MS. MELLISSA LATOYA JAGRUP, LMHC
Title: PROPRIETER
Phone: (813) 748-2912

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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