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General NPI Number Information
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NPI Number | 1851696579
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Entity Type | Organization
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Legal Business Name | HUMAN SERVICE & RESOURCES & ASSOCIATES
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 220 LIVE OAK BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-3830
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Country | US
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Telephone | 407-767-0039
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Fax | 407-767-7490
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Provider Business Mailing Address
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Address Line | 220 LIVE OAK BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-3830
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Country | US
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Telephone | 407-767-0039
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Fax | 407-767-7490
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. PHYLLIS A. OLIVA
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Credential | CAP, NCACII
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Telephone | 407-767-0039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1859AD468901
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License Number State | FL
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