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Organization
COMMUNITY VICTORY FAMILY SERVICES INC
Active
Organization
COMMUNITY VICTORY FAMILY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAIWAN SIMMONS (DIRECTOR OF OPERATIONS)
(800) 715-3606
Entity
Organization
Contact information
Practice address
8905 REGENTS PARK DR STE 230, TAMPA, FL 33647-3081
(800) 715-3606
Mailing address
PO BOX 7731, WESLEY CHAPEL, FL 33545-0113
(800) 715-3606
(813) 906-0206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014618400
—
FL
Enumeration date
06/26/2018
Last updated
06/26/2018
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