Provider Demographics
NPI:1447413562
Name:CONNECTIONS OUTREACH, INC.
Entity Type:Organization
Organization Name:CONNECTIONS OUTREACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-721-5259
Mailing Address - Street 1:4044 W LAKE MARY BLVD # 104-317
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2012
Mailing Address - Country:US
Mailing Address - Phone:407-721-5259
Mailing Address - Fax:
Practice Address - Street 1:4044 W LAKE MARY BLVD # 104-317
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2012
Practice Address - Country:US
Practice Address - Phone:407-721-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW7437251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health