National Provider Identifier Database

LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL INC
Mental Health (Including Community Mental Health Center)

Contact Information

LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC
1604 17TH TER NE
WINTER HAVEN, FL  33881-4416
Phone: 863-288-1635
Fax:
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health 261QM0855X
Adult Mental Health 261QM0850X
Case Management 251B00000X
Local Education Agency (LEA) 251300000X
Rehabilitation, Substance Use Disorder Unit 276400000X
Religious Nonmedical Health Care Institution 282J00000X
Student Health 261QS1000X

* Indicates primary specialty

NPI Profile & details for LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC

NPI Number 1386295095
Legal business name
LBN		 LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC
Authorized official ABRAHAM TIRADO AYALA - (MENTAL HEALTH CARE)
Entity Organization
Organization subpart No
Enumeration date 09/24/2019
Last updated 07/23/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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