Innovation Counseling Center

NPI 1164818217 - Counselor - 101YM0800X

NPI Details
NPI 1164818217
Enumeration Date 04/15/2015
Last Updated 02/23/2016
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name ANGELA ANGELA
Position CEO
Phone (904) 274-6255
Fax
Practice Location
9951 ATLANTIC BLVD
442
JACKSONVILLE FL, 32225-6584, US
Phone (904) 274-6255
Fax
Business Location
9951 ATLANTIC BLVD
442
JACKSONVILLE FL, 32225-6584, US
Phone (904) 327-4261
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State Florida
License Number MH13087
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According to our database, Innovation Counseling Center NPI is 1164818217, taxonomy code is 101YM0800X and license number is MH13087, license state is located at Florida. Innovation Counseling Center physically located at 9951 Atlantic Blvd, Jacksonville FL, 32225-6584. NPI Number 1033115704 has the healthcare provider type.

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1164818217 NPI number is provided on an as is basis without warranty of any kind. 1164818217 is maintained by the National Plan & Provider Enumeration System. The contents of Innovation Counseling Center are for informational purposes only.