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General NPI Number Information
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NPI Number | 1871264507
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Entity Type | Organization
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Legal Business Name | HEART & LIFE COMMUNITY CENTER INC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 309 NE 1ST ST STE B
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City | GAINESVILLE
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State | FL
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Zip | 32601-5310
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Country | US
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Telephone | 407-730-5306
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Fax | 407-730-5305
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Provider Business Mailing Address
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Address Line | 801 N MAGNOLIA AVE STE 201
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City | ORLANDO
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State | FL
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Zip | 32803-3842
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Country | US
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Telephone | 407-730-5306
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Fax | 407-730-5305
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARMEN GUZMAN
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Credential | CCMS
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Telephone | 407-730-5306
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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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