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General NPI Number Information
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NPI Number | 1649692112
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Entity Type | Organization
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Legal Business Name | BRIDGE BUILDERS AOAF CENTRAL
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 6873 W COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32818-6827
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Country | US
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Telephone | 407-296-0002
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Fax | 407-295-2008
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Provider Business Mailing Address
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Address Line | 6873 W. COLONIAL DR..
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City | ORLANDO
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State | FL
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Zip | 32818
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Country | US
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Telephone | 407-296-0002
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Fax | 407-295-2008
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Authorized Official
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Title or Position | OWNER
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Name | DELORIS WILLIAMS BATTLE
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Credential |
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Telephone | 407-296-0002
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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 | 25B00000X
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License Number State | FL
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