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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
LETICIA UBILLUS (CEO)
(407) 564-0636
Entity
Organization

Contact information

Practice address
1802 N ALAFAYA TRL, ORLANDO, FL 32826-4716
(407) 564-0636
Mailing address
PO BOX 782339, ORLANDO, FL 32878-2339
(407) 564-0636

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/17/2021
Last updated
05/19/2021
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