Grove, Alisa D
Grove, Alisa D is an sole proprietor health care provider with primary practice located at 4408 Bedford Way , Leesburg FL 34748-1321. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Grove, Alisa D can be contacted via phone (407) 421-2031.Contact Information
Primary practice address
4408 Bedford Way
Leesburg FL 34748-1321
Phone: (407) 421-2031
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1982986733 |
|---|---|
| LBN Legal business name | Grove, Alisa D |
| Credentials | M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2011 |
| Last updated | May 30th, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982986733 | NPPES |
| Florida | MEDICAID | 122073300 |
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