Organization
CJA SUPPORT CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN JOAN APONTE (AGENCY DIRECTOR)
(407) 483-9520
Entity
Organization
Contact information
Practice address
809 E OAK ST, SUITE 105, KISSIMMEE, FL 34744-5834
(407) 483-9520
(407) 483-9551
Mailing address
809 E OAK ST, SUITE 105, KISSIMMEE, FL 34744-5834
(407) 483-9520
(407) 483-9551
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
684629796
FL
253Z00000X
In Home Supportive Care Agency
684629796
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
684629796
—
FL
Enumeration date
11/11/2015
Last updated
07/06/2016
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