Provider Demographics
NPI:1629479241
Name:HEALTH ENRICHMENT LIFESKILLE PROGRAM
Entity Type:Organization
Organization Name:HEALTH ENRICHMENT LIFESKILLE PROGRAM
Other - Org Name:HELP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:407-694-6100
Mailing Address - Street 1:2332 N HIAWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3961
Mailing Address - Country:US
Mailing Address - Phone:407-298-7080
Mailing Address - Fax:
Practice Address - Street 1:2332 N HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3961
Practice Address - Country:US
Practice Address - Phone:407-298-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management