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General NPI Number Information
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NPI Number | 1346982014
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Entity Type | Organization
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Legal Business Name | ROLAND RESOURCES LLC
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 225 MAIN ST STE 7A
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City | DESTIN
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State | FL
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Zip | 32541-2550
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Country | US
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Telephone | 850-404-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CALHOUN AVE UNIT 606
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City | DESTIN
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State | FL
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Zip | 32541-5511
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Country | US
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Telephone | 850-404-2294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLEN HORNE
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Credential |
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Telephone | 850-404-2294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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