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Organization

BEHAVIORAL SUPPORT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA D LEMONS (PSYCHOSOCIAL REHAB SPECIALIST)
(321) 443-9191
Entity
Organization

Contact information

Practice address
371 MICHIGAN ESTATES CIR, SAINT CLOUD, FL 34769-5334
(321) 443-9191
Mailing address
371 MICHIGAN ESTATES CIR, SAINT CLOUD, FL 34769-5334

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
12/07/2011
Last updated
12/07/2011
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