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Organization
LUCKY BEHAVIOR SERVICES CORP
Active
Organization
LUCKY BEHAVIOR SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARELIA MARIA FERNANDEZ (PRESIDENT)
(239) 298-6868
Entity
Organization
Contact information
Practice address
3048 DEL PRADO BLVD., UNIT 125, CAPE CORAL, FL 33904-7283
(239) 298-6868
Mailing address
2804 DEL PRADO BLVD S STE 209-2, CAPE CORAL, FL 33904-7283
(239) 298-6868
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/06/2021
Last updated
05/12/2021
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