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General NPI Number Information
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NPI Number | 1528830882
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Entity Type | Organization
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Legal Business Name | ECKERD YOUTH ALTERNATIVES, INC. DBA ECKERD CONNECTS
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 990 N CORPORATE DR STE 212
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City | HARAHAN
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State | LA
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Zip | 70123-3331
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Country | US
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Telephone | 318-464-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N STARCREST DR
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City | CLEARWATER
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State | FL
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Zip | 33765-3224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | NICOLE STROEBEL
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Credential |
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Telephone | 727-461-2990
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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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