Organization
A GREAT LIFE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANERA ECHEVARRIA LMHC, BCABA (CEO)
(407) 702-5258
Entity
Organization
Contact information
Practice address
1150 S SEMORAN BLVD STE A, ORLANDO, FL 32807-1424
(407) 704-7811
(407) 382-0659
Mailing address
15031 PERDIDO DR, ORLANDO, FL 32828-5216
(407) 702-5258
(407) 382-0659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMHC 10628
FL
103K00000X
Behavior Analyst
0-05-1761
FL
251E00000X
Home Health Agency
P06000053181
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004774200
—
FL
01
—
691558201
MEDICAID AGED/DISABLED ADULTS
FL
01
—
691558202
MEDICAID PERSONAL CARE
FL
05
—
691558296
—
FL
Enumeration date
01/30/2007
Last updated
09/12/2018
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