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General NPI Number Information
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NPI Number | 1043957426
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Entity Type | Organization
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Legal Business Name | FRIENDS THAT CARE, LLC
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 8530 N WICKHAM RD STE 112
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City | MELBOURNE
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State | FL
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Zip | 32940-6616
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Country | US
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Telephone | 321-914-9245
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Fax |
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Provider Business Mailing Address
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Address Line | 8530 N WICKHAM RD STE 112
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City | MELBOURNE
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State | FL
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Zip | 32940-6616
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Country | US
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Telephone | 321-914-9245
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARONDA T COURTNEY
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Credential |
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Telephone | 321-914-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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