# KOINONIA DYNAMIS INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083858112
- **Authorized official:** MS. ADDRIS BLANCHE VINSON LMHC, CRC (CEO)
- **Authorized official phone:** (904) 354-6005

## Contact information

- **Practice address:** 1734 HIRAM ST, JACKSONVILLE, FL 32209-6105
- **Practice address phone:** (904) 354-6005
- **Practice address fax:** (904) 354-6005
- **Mailing address:** 1734 HIRAM ST, JACKSONVILLE, FL 32209-6105
- **Mailing address phone:** (904) 354-6005
- **Mailing address fax:** (904) 354-6005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | MH9044 | FL | Yes |

## Other

- **Enumeration date:** 04/20/2009
- **Last updated:** 04/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1285766840 | — | FL |