Healthcare Provider Details

I. General information

NPI: 1326249491
Provider Name (Legal Business Name): EMMAUS COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 TURNBULL AVE
ALTAMONTE SPRINGS FL
32701-6420
US

IV. Provider business mailing address

711 TURNBULL AVE
ALTAMONTE SPRINGS FL
32701-6420
US

V. Phone/Fax

Practice location:
  • Phone: 407-740-5575
  • Fax: 407-834-0832
Mailing address:
  • Phone: 407-740-5575
  • Fax: 407-834-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH2710
License Number StateFL

VIII. Authorized Official

Name: DR. GORDON D HOBBIE
Title or Position: DIRECTOR PRESIDENT
Credential: LMHC
Phone: 407-740-5575