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General NPI Number Information
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NPI Number | 1649375650
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Entity Type | Organization
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Legal Business Name | LDS FAMILY SERVICES
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 10502 SATELLITE BLVD STE D
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City | ORLANDO
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State | FL
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Zip | 32837-8479
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Country | US
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Telephone | 407-850-9141
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Fax | 407-850-9687
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Provider Business Mailing Address
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Address Line | 10502 SATELLITE BLVD STE D
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City | ORLANDO
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State | FL
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Zip | 32837-8479
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Country | US
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Telephone | 407-850-9141
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Fax | 407-850-9687
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | ADAM BARNES
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Credential | PMH
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Telephone | 407-850-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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