Organization
PRESERVERS OF DESTINIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISOL LUGO (PRESIDENT)
(407) 429-1144
Entity
Organization
Contact information
Practice address
1621 E VINE ST, KISSIMMEE, FL 34744-3730
(407) 429-1144
Mailing address
1621 E VINE ST, KISSIMMEE, FL 34744-3730
(407) 847-4152
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/25/2015
Last updated
08/17/2021
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