Organization
CHANGES YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMARA LEE MOHAMMD LMHC, NCC (PROGRAM COORDINATOR)
(321) 348-7304
Entity
Organization
Contact information
Practice address
2040 WINTER SPRINGS BLVD, OVIEDO, FL 32765-9347
(321) 348-7304
(321) 765-4871
Mailing address
2040 WINTER SPRINGS BLVD, OVIEDO, FL 32765-9347
(321) 348-7304
(321) 765-4871
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/18/2013
Last updated
10/18/2013
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