Provider Demographics
NPI:1942897582
Name:VONOSTIR INNOVATION SERVICES, L.L.C.
Entity Type:Organization
Organization Name:VONOSTIR INNOVATION SERVICES, L.L.C.
Other - Org Name:VONOSTIR INNOVATION SERVICES, L.L.C
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:WILHELM
Authorized Official - Last Name:OSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MAT, MS, MSW, LCSW
Authorized Official - Phone:904-290-4601
Mailing Address - Street 1:1406 KINGSLEY AVE UNIT A2
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4590
Mailing Address - Country:US
Mailing Address - Phone:904-290-4601
Mailing Address - Fax:904-290-4587
Practice Address - Street 1:1406 KINGSLEY AVE UNIT A2
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4590
Practice Address - Country:US
Practice Address - Phone:904-290-4601
Practice Address - Fax:904-290-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty