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General NPI Number Information
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NPI Number | 1366022832
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Entity Type | Organization
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Legal Business Name | OUR VILLAGE OKEECHOBEE
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 205 NE 2ND ST
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City | OKEECHOBEE
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State | FL
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Zip | 34972-2974
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Country | US
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Telephone | 863-697-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 205 NE 2ND ST
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City | OKEECHOBEE
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State | FL
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Zip | 34972-2974
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Country | US
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Telephone | 863-697-8718
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LEAH D SUAREZ
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Credential |
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Telephone | 863-697-8718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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