Provider Demographics
NPI:1417548728
Name:INSCAPE HEALTH GROUP LLC
Entity Type:Organization
Organization Name:INSCAPE HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL; PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:SELENA
Authorized Official - Last Name:HAYNES ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-209-7428
Mailing Address - Street 1:1970 MICHIGAN AVE BLDG E
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-5723
Mailing Address - Country:US
Mailing Address - Phone:407-209-7428
Mailing Address - Fax:
Practice Address - Street 1:1970 MICHIGAN AVE BLDG E
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-5723
Practice Address - Country:US
Practice Address - Phone:407-209-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty