Provider Demographics
NPI:1033653779
Name:AKESO BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:AKESO BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:407-325-2235
Mailing Address - Street 1:6100 LAKE ELLENOR DR STE 212
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4632
Mailing Address - Country:US
Mailing Address - Phone:407-325-2235
Mailing Address - Fax:
Practice Address - Street 1:6100 LAKE ELLENOR DR
Practice Address - Street 2:#212
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4614
Practice Address - Country:US
Practice Address - Phone:407-325-2235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health