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General NPI Number Information
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NPI Number | 1639413784
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Entity Type | Organization
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Legal Business Name | LEARNING ALTERNATIVE BEHAVIORS, YOUTH AND FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 11 S CALHOUN ST
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City | QUINCY
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State | FL
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Zip | 32351-3170
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Country | US
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Telephone | 850-627-6220
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Fax | 850-627-6229
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Provider Business Mailing Address
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Address Line | 45 MAKAYLA LN
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City | QUINCY
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State | FL
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Zip | 32352-3201
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Country | US
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Telephone | 850-509-4825
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LATOYA TOMEKA BOYD
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Credential | LMHC
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Telephone | 850-509-4825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH11334
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License Number State | FL
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