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General NPI Number Information
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NPI Number | 1851312946
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Entity Type | Organization
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Legal Business Name | COURT EDUCATIONAL PROGRAMS
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 E MAIN ST
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City | TAVARES
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State | FL
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Zip | 32778-3808
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Country | US
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Telephone | 352-343-9399
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Fax | 352-343-8881
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Provider Business Mailing Address
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Address Line | 220 E MAIN ST
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City | TAVARES
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State | FL
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Zip | 32778-3808
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Country | US
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Telephone | 352-343-9399
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Fax | 352-343-8881
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Authorized Official
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Title or Position | DIRECTOR
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Name | REBECCA GAIL HERBST
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Credential | BA, CCJAP
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Telephone | 352-343-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1335AD6368
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License Number State | FL
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