Healthcare Provider Details

I. General information

NPI: 1265794507
Provider Name (Legal Business Name): HEALTHY FAMILIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 LANGDALE DR
ORLANDO FL
32808-2081
US

IV. Provider business mailing address

4715 LANGDALE DR
ORLANDO FL
32808-2081
US

V. Phone/Fax

Practice location:
  • Phone: 407-683-6083
  • Fax: 407-730-4810
Mailing address:
  • Phone: 407-683-6083
  • Fax: 407-730-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DOMINIQUE MATHURIN
Title or Position: CEO
Credential: M.S.
Phone: 407-683-6083