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General NPI Number Information
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NPI Number | 1578875605
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Entity Type | Organization
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Legal Business Name | THE NDAR CORPORATION
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 2056 ALOMA AVE SUITE 100
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City | WINTER PARK
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State | FL
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Zip | 32792-3340
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Country | US
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Telephone | 407-629-0413
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Fax | 407-629-2603
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Provider Business Mailing Address
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Address Line | 2056 ALOMA AVE SUITE 100
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City | WINTER PARK
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State | FL
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Zip | 32792-3340
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Country | US
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Telephone | 407-629-0413
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Fax | 407-629-2603
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT J NIES JR.
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Credential | PRESIDENT
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Telephone | 407-629-0413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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