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General NPI Number Information
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NPI Number | 1780221903
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Entity Type | Organization
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Legal Business Name | ECHO COMMUNITY OUTREACH INC
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 520 PALM COAST PKWY SW STE 103
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City | PALM COAST
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State | FL
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Zip | 32137-4743
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Country | US
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Telephone | 386-225-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 520 PALM COAST PKWY SW STE 103
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City | PALM COAST
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State | FL
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Zip | 32137-4743
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Country | US
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Telephone | 386-225-4940
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | ROBERT RAMIREZ
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Credential |
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Telephone | 386-225-4940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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