Organization
LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC
Active
Other names
Liderazgo y Estilo De Vida, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABRAHAM TIRADO AYALA CBHCM (MENTAL HEALTH CARE)
(863) 288-1635
Entity
Organization
Contact information
Practice address
1604 17TH TER NE, WINTER HAVEN, FL 33881-4416
(863) 288-1635
Mailing address
1604 17TH TER NE, WINTER HAVEN, FL 33881-4416
(863) 288-1635
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
Other
Enumeration date
09/24/2019
Last updated
07/23/2021
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