MEDICARE: VOICE OF DISTRESS RELIEVED, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251V00000X	Voluntary or Charitable Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM1000X	Migrant Health Clinic/Center
4	171M00000X	Case Manager/Care Coordinator
5	171R00000X	Interpreter
6	101YA0400X	Addiction (Substance Use Disorder) Counselor
7	101YM0800X	Mental Health Counselor
8	405300000X	Prevention Professional
9	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1578918819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOICE OF DISTRESS RELIEVED, INC

Provider Business Mailing Address
First Line	:	772 W LUMSDEN RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-6260
Country	:	US
Telephone Number	:	813-685-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	772 W LUMSDEN RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-6260
Country	:	US
Telephone Number	:	813-685-6700
Fax Number	:

Authorized Official
Title or Position	:	CHAIRPERSON
Name	:	GESNER DULCIO
Credential	:
Telephone Number	:	813-685-6700

Provider Enumeration Date	:	04/23/2016
Last Update Date	:	09/10/2019

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