Mellow Jac

LBN: Mellow Jac
Mellow Jac is an health care organization with primary practice located at 108 Lilac Dr , Kissimmee FL 34743-6345. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty. Mellow Jac can be contacted via phone (407) 734-3417, or through Pereira, Amie via phone (407) 615-0448.

Contact Information

Primary practice address
108 Lilac Dr Kissimmee FL 34743-6345
Phone: (407) 734-3417
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pereira, Amie
Phone: (407) 615-0448

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1396348082
LBN Legal business name Mellow Jac
DBA Doing business as
Authorized official Pereira, Amie
Entity Organization
Organization subpart 1 No
Enumeration date Nov 17th, 2020
Last updated Nov 17th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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