Florida Mentor

NPI 1134285141 - Day Training, Developmentally Disabled Services - 251C00000X

NPI Details
NPI 1134285141
Enumeration Date 12/28/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name EDWARD DEMETRICE EDWARD
Position ADMINISTRATOR
Phone (386) 274-4172
Fax (386) 274-5568
Practice Location
1725 5TH STREET
DAYTONA BEACH FL, 32117-5107, US
Phone (386) 274-4172
Fax (386) 274-5568
Business Location
1725 FIFTH ST
DAYTONA BEACH FL, 32117-5107, US
Phone (386) 274-4172
Fax (386) 274-5568
Toxanomy
Taxonomy Code 251C00000X
License State Florida
License Number 03125760
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According to our database, Florida Mentor NPI is 1134285141, taxonomy code is 251C00000X and license number is 03125760, license state is located at Florida. Florida Mentor physically located at 1725 5th Street, Daytona Beach FL, 32117-5107. NPI Number 1033115704 has the healthcare provider type.

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1134285141 NPI number is provided on an as is basis without warranty of any kind. 1134285141 is maintained by the National Plan & Provider Enumeration System. The contents of Florida Mentor are for informational purposes only.