Provider Demographics
NPI:1154653251
Name:JENICA, INC.
Entity Type:Organization
Organization Name:JENICA, INC.
Other - Org Name:A NEW PERSPECTIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-923-9543
Mailing Address - Street 1:1209 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1413
Mailing Address - Country:US
Mailing Address - Phone:407-792-0900
Mailing Address - Fax:321-363-4835
Practice Address - Street 1:1209 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1413
Practice Address - Country:US
Practice Address - Phone:407-792-0900
Practice Address - Fax:321-363-4835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH2491251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health