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General NPI Number Information
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NPI Number | 1669836995
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Entity Type | Organization
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Legal Business Name | ALLIANCE AWARENESS CENTER INC.
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 390 N ORANGE AVE SUITE 2300
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City | ORLANDO
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State | FL
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Zip | 32801-1640
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Country | US
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Telephone | 877-646-3374
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Fax | 321-234-9267
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Provider Business Mailing Address
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Address Line | 390 N ORANGE AVE SUITE 2300
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City | ORLANDO
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State | FL
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Zip | 32801-1640
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Country | US
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Telephone | 877-646-3374
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Fax | 321-234-9267
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Authorized Official
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Title or Position | CEO/OWNER/FOUNDER
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Name | MR. THEODORE ODEM JR.
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Credential |
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Telephone | 877-646-3374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | FL
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