| Community Victory Family Services Inc | |
|
8905 Regents Park Dr Ste 230 Tampa FL 33647-3081 | |
| (800) 715-3606 | |
| Not Available |
| Full Name | Community Victory Family Services Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 8905 Regents Park Dr Ste 230, Tampa, Florida |
| Authorized Official Name and Position | Taiwan Simmons (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8007153606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Victory Family Services Inc Po Box 7731 Wesley Chapel FL 33545-0113 Ph: (800) 715-3606 | Community Victory Family Services Inc 8905 Regents Park Dr Ste 230 Tampa FL 33647-3081 Ph: (800) 715-3606 |
| NPI Number | 1346735008 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 06/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346735008 | NPI | - | NPPES |
| 014618400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH13166 (Florida) | Primary |
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