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Organization
YOUTH AGAINST SUBSTANCE ABUSE, INC
Active
Organization
YOUTH AGAINST SUBSTANCE ABUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VONZELIA PICKETT MANGHAM BSW/TCM (DIRECTOR/TARGET CASE MANGHAM)
(407) 970-8019
Entity
Organization
Contact information
Practice address
5004 BRIAR OAKS CIRCLE, ORLANDO, FL 32808-1708
(407) 970-8019
(407) 578-3094
Mailing address
5004 BRIAR OAKS CIRCLE, ORLANDO, FL 32808-1708
(407) 970-8019
(407) 578-3094
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001674900
—
FL
Enumeration date
12/08/2010
Last updated
12/08/2010
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