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General NPI Number Information
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NPI Number | 1487009023
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Entity Type | Organization
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Legal Business Name | TCM OF FLORIDA INC
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 350 N WASHINGTON AVE SUITE K
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City | TITUSVILLE
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State | FL
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Zip | 32796-5806
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Country | US
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Telephone | 321-222-0172
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Fax | 888-859-2513
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Provider Business Mailing Address
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Address Line | 350 N WASHINGTON AVE SUITE K
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City | TITUSVILLE
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State | FL
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Zip | 32796-5806
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Country | US
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Telephone | 321-222-0172
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Fax | 888-859-2513
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ROSA GRANT
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Credential | MS
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Telephone | 407-466-6327
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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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