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General NPI Number Information
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NPI Number | 1275775694
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Entity Type | Organization
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Legal Business Name | GULFSTREAM GOODWILL INDUSTRIES, INC.
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 03/31/2009
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Provider Practice Location Address
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Address Line | 1715 TIFFANY DR E
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3224
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Country | US
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Telephone | 561-848-7200
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Fax | 561-848-0346
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Provider Business Mailing Address
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Address Line | 1715 TIFFANY DR E
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3224
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Country | US
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Telephone | 561-848-7200
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Fax | 561-848-0346
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Authorized Official
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Title or Position | VP, HUMAN SERVICES
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Name | MRS. KATHRYN SPENCER
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Credential |
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Telephone | 561-848-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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