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General NPI Number Information
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NPI Number | 1508007899
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Entity Type | Organization
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Legal Business Name | GAINESVILLE OPPORTUNITY CENTER
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 1717 NE 9TH ST BUILDING A, SUITE 140
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City | GAINESVILLE
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State | FL
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Zip | 32609-3797
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Country | US
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Telephone | 352-224-5523
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Fax | 352-224-5555
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Provider Business Mailing Address
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Address Line | 1717 NE 9TH ST BUILDING A, SUITE 140
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City | GAINESVILLE
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State | FL
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Zip | 32609-3797
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Country | US
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Telephone | 352-224-5523
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Fax | 352-224-5555
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MICHAEL JOSEPH DEMERS
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Credential |
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Telephone | 352-224-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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