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NPI Code Detail

MEDICARE: CFSATC, INC.

MEDICARE: CFSATC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency0705AD119402FL

General Provider Information

NPI Number : 1356548721
Entity Type Code : Organization
Provider Name (Legal Business Name) : CFSATC, INC.
Provider Business Mailing Address
First Line : 2198 HARRIS AVE NE
Second Line :
City : PALM BAY
State : FL
Zip : 32905-4002
Country : US
Telephone Number : 321-951-9750
Fax Number : 321-951-9765
Provider Business Practice Location Address
First Line : 2198 HARRIS AVE NE
Second Line :
City : PALM BAY
State : FL
Zip : 32905-4002
Country : US
Telephone Number : 321-951-9750
Fax Number : 321-951-9765
Authorized Official
Title or Position : REGIONAL DIRECTOR
Name : MR. DAVE KNEESSY
Credential : MS, MAC, MCAP, LMHC
Telephone Number : 321-951-9750
Provider Enumeration Date : 06/29/2007
Last Update Date : 05/19/2020

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Directions to “CFSATC, INC. ” Practice Location

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