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General NPI Number Information
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NPI Number | 1386900447
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Entity Type | Organization
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Legal Business Name | LIVING STONES INTERNATIONAL, INC.
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 604 EUGENIA ST
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City | TALLAHASSEE
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State | FL
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Zip | 32310-4818
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Country | US
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Telephone | 850-765-0320
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Fax | 850-765-0485
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Provider Business Mailing Address
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Address Line | PO BOX 6747
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City | TALLAHASSEE
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State | FL
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Zip | 32314-6747
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Country | US
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Telephone | 850-765-0320
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Fax | 850-765-0485
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JOSEPHINE GAMBOA-MONTGOMERY
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Credential |
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Telephone | 850-765-0320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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