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Organization

DYNAMIC YOUTH SUPPORT SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANTE LEVELL JOHNSON (PRESIDENT)
(407) 770-7611
Entity
Organization

Contact information

Practice address
823 W CENTRAL BLVD, ORLANDO, FL 32805-1808
(407) 347-7396
Mailing address
PO BOX 550116, ORLANDO, FL 32855-0116
(407) 347-7396

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
03802013876
FL

Other

Enumeration date
06/20/2013
Last updated
06/20/2013
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