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General NPI Number Information
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NPI Number | 1558591941
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Entity Type | Organization
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Legal Business Name | CELEBRATE THE STRUGGLE LLC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 941 VILLAGE TRAIL
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City | PORT ORANGE
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State | FL
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Zip | 32127-9353
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Country | US
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Telephone | 386-756-3480
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Fax | 386-788-3429
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Provider Business Mailing Address
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Address Line | 941 VILLAGE TRL
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City | PORT ORANGE
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State | FL
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Zip | 32127-9353
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Country | US
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Telephone | 386-756-3480
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Fax | 386-788-3429
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Authorized Official
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Title or Position | MEMBER/ADMINISTRATOR
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Name | MR. STEVEN SCHRUNK
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Credential |
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Telephone | 386-756-3480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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