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General NPI Number Information
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NPI Number | 1396940391
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Entity Type | Organization
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Legal Business Name | COUNSELING & REHABILITATION ASSOCIATES INC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2760 SE 17TH STREET
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-854-5880
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Fax | 352-378-1828
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Provider Business Mailing Address
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Address Line | PO BOX 90308
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City | GAINESVILLE
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State | FL
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Zip | 32607
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Country | US
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Telephone | 352-378-2600
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Fax | 352-378-1828
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT P HOSFORD
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Credential | PHD
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Telephone | 352-378-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | M11854
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License Number State | FL
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