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General NPI Number Information
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NPI Number | 1245416577
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Entity Type | Organization
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Legal Business Name | CENTER FOR GLOBAL HEALTH & HUMANITY SERVICES
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 1721 SW GLORIA LN
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-1554
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Country | US
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Telephone | 772-446-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 SW GLORIA LN
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-1554
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Country | US
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Telephone | 772-446-0389
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL MICHAEL UKPONG
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Credential | MPH
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Telephone | 772-446-0389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | N05000007078
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | N05000007078
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | N05000007078
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | N05000007078
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N05000007078
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | N05000007078
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License Number State | FL
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