Provider Demographics
NPI:1639621568
Name:HOPE COUNSELING OF CENTRAL FL, LLC
Entity Type:Organization
Organization Name:HOPE COUNSELING OF CENTRAL FL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIANIS
Authorized Official - Middle Name:JALIERIS
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-288-6417
Mailing Address - Street 1:1905 MAGICAL LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5516
Mailing Address - Country:US
Mailing Address - Phone:407-906-5214
Mailing Address - Fax:
Practice Address - Street 1:241 RUBY AVE
Practice Address - Street 2:UNIT 213
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5627
Practice Address - Country:US
Practice Address - Phone:407-906-5214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14082261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health