Organization
INNER AWAKENING THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL M CEBALLOS-ROSARIO LMHC (OWNER)
(407) 906-8633
Entity
Organization
Contact information
Practice address
1575 DETRICK AVE, DELAND, FL 32724-2042
(407) 906-8633
Mailing address
1575 DETRICK AVE, DELAND, FL 32724-2042
(407) 906-8633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MH14780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205325297
—
FL
Enumeration date
05/04/2018
Last updated
10/04/2021
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