Healthcare Provider Details

I. General information

NPI: 1013151406
Provider Name (Legal Business Name): THRESHOLD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 N GOLDENROD RD
WINTER PARK FL
32792-8823
US

IV. Provider business mailing address

3550 N GOLDENROD RD
WINTER PARK FL
32792-8823
US

V. Phone/Fax

Practice location:
  • Phone: 407-671-7060
  • Fax:
Mailing address:
  • Phone: 407-671-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WRIGHT
Title or Position: CEO
Credential:
Phone: 407-671-7060