Healthcare Provider Details

I. General information

NPI: 1073738415
Provider Name (Legal Business Name): JOYCE FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22452 LAURELDALE DR
LUTZ FL
33549-8783
US

IV. Provider business mailing address

22452 LAURELDALE DR
LUTZ FL
33549-8783
US

V. Phone/Fax

Practice location:
  • Phone: 800-460-1416
  • Fax: 800-460-1416
Mailing address:
  • Phone: 800-460-1416
  • Fax: 800-460-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number686478396
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number686478396
License Number StateFL

VIII. Authorized Official

Name: JOYCE FRANCIS
Title or Position: DIRECTOR,OWNER
Credential:
Phone: 800-460-1416