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NPI Code Detail

MEDICARE: COOPERATIVE ADVENTURES, INC.

MEDICARE: COOPERATIVE ADVENTURES, 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
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1821256231
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOPERATIVE ADVENTURES, INC.
Provider Business Mailing Address
First Line : 1208 NW 6TH ST
Second Line : SUITE A
City : GAINESVILLE
State : FL
Zip : 32601-4245
Country : US
Telephone Number : 352-384-0909
Fax Number : 352-384-1752
Provider Business Practice Location Address
First Line : 1208 NW 6TH ST
Second Line : SUITE A
City : GAINESVILLE
State : FL
Zip : 32601-4245
Country : US
Telephone Number : 352-384-0909
Fax Number : 352-384-1752
Authorized Official
Title or Position : OWNER
Name : GWENNE GORMAN
Credential :
Telephone Number : 352-384-0909
Provider Enumeration Date : 06/02/2008
Last Update Date : 06/02/2008

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