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General NPI Number Information
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NPI Number | 1235671421
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Entity Type | Organization
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Legal Business Name | PROJECT D.A.L.E. INC.
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Dates
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Enumeration Date | 11/06/2016
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Last Update Date | 11/06/2016
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Provider Practice Location Address
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Address Line | 1661 RINGLING BLVD #2631
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City | SARASOTA
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State | FL
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Zip | 34230-7000
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Country | US
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Telephone | 941-404-8382
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Fax | 248-769-6154
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Provider Business Mailing Address
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Address Line | PO BOX 2631
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City | SARASOTA
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State | FL
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Zip | 34230-2631
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Country | US
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Telephone | 941-404-8382
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Fax | 248-769-6154
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Authorized Official
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Title or Position | PRESIDENT/CHIEF EXECUTIVE OFFICER
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Name | MR. WALLACE DASHER III
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Credential | M.S.
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Telephone | 941-404-8382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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