Organization
CENTER FOR INDEPENDENT LIVING IN CENTRAL FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA P JACK MS (MENTAL HEALTH COUNSELOR)
(407) 623-1070
Entity
Organization
Contact information
Practice address
720 N. DENNING DR., WINTER PARK, FL 32789
(407) 623-1070
(407) 623-1390
Mailing address
720 N. DENNING DR., WINTER PARK, FL 32789
(407) 623-1070
(407) 623-1390
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH8933
FL
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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