Organization
RAVEN ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIAN RACE (OWNER)
(407) 616-5948
Entity
Organization
Contact information
Practice address
1550 LAKE BALDWIN LN, SUITE B, ORLANDO, FL 32814-6680
(407) 616-5948
Mailing address
PO BOX 532023, ORLANDO, FL 32853-2023
(407) 616-5948
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
IMH12406
FL
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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