Provider Demographics
NPI:1164011805
Name:SCHULTZ MENTAL HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:SCHULTZ MENTAL HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:904-707-2897
Mailing Address - Street 1:2080 TURTLE MOUND RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8109
Mailing Address - Country:US
Mailing Address - Phone:321-722-7787
Mailing Address - Fax:
Practice Address - Street 1:2080 TURTLE MOUND RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-8109
Practice Address - Country:US
Practice Address - Phone:321-722-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-17
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty