Provider Demographics
NPI:1851001580
Name:NOT BY CHANCE MENTAL HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:NOT BY CHANCE MENTAL HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANZOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-570-0522
Mailing Address - Street 1:2442 FULFORD RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-4347
Mailing Address - Country:US
Mailing Address - Phone:850-570-0522
Mailing Address - Fax:850-204-4100
Practice Address - Street 1:2442 FULFORD RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-4347
Practice Address - Country:US
Practice Address - Phone:850-570-0522
Practice Address - Fax:850-204-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty