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General NPI Number Information
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NPI Number | 1437587086
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Entity Type | Organization
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Legal Business Name | HABILITATIVE SERVICES OF NORTH FLORIDA
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 4440 PUTNAM ST
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City | MARIANNA
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State | FL
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Zip | 32446-3455
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Country | US
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Telephone | 850-482-5391
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Fax | 850-482-2833
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Provider Business Mailing Address
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Address Line | 4440 PUTNAM ST
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City | MARIANNA
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State | FL
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Zip | 32446-3455
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Country | US
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Telephone | 850-482-5391
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Fax | 850-482-2833
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. NATALIE HARDY
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Credential |
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Telephone | 850-482-5391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 670805696
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License Number State | FL
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