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General NPI Number Information
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NPI Number | 1770292989
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Entity Type | Organization
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Legal Business Name | K & V COMMUNITY HEALTH SERVICES INC.
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 5393 CARRARA CT
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8048
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Country | US
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Telephone | 407-924-2124
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Fax |
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Provider Business Mailing Address
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Address Line | 9145 NARCOOSSEE RD SUITE 106 PMB 109
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City | ORLANDO
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State | FL
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Zip | 32827
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Country | US
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Telephone | 407-924-2124
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KHALIL COLLAZO
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Credential |
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Telephone | 407-924-2124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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