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General NPI Number Information
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NPI Number | 1881263010
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Entity Type | Organization
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Legal Business Name | A CORE CONNECTION SERVICES AND CONSULTING, LLC
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2884 S OSCEOLA AVE
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City | ORLANDO
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State | FL
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Zip | 32806-5431
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Country | US
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Telephone | 407-789-2673
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Fax | 407-612-2359
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Provider Business Mailing Address
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Address Line | 2135 W STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32779-4983
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Country | US
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Telephone | 407-789-2673
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Fax | 407-612-2359
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Authorized Official
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Title or Position | OWNER
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Name | KELLY GREENE
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Credential |
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Telephone | 407-639-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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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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