Healthcare Provider Details

I. General information

NPI: 1225118821
Provider Name (Legal Business Name): CHILDREN'S HOME SOCIETY OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S DE VILLIERS ST
PENSACOLA FL
32502-5511
US

IV. Provider business mailing address

5766 S SEMORAN BLVD
ORLANDO FL
32822-4818
US

V. Phone/Fax

Practice location:
  • Phone: 850-266-2701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EILEEN TOSOLINI
Title or Position: PROVIDER RELATIONS MANAGER
Credential:
Phone: 407-375-2565