Organization
KALIVIA S ANGELIC HANDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KESI WILLIAMS MSW (EXECUTIVE DIRECTOR)
(850) 756-9785
Entity
Organization
Contact information
Practice address
70 RICHARDSON DR, HAVANA, FL 32333-5375
(850) 756-9785
Mailing address
70 RICHARDSON DR, HAVANA, FL 32333-5375
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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