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General NPI Number Information
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NPI Number | 1962178632
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Entity Type | Organization
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Legal Business Name | ACADEMY AT GLENGARY, INC
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 08/21/2021
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Provider Practice Location Address
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Address Line | 1910 GLENGARY ST
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City | SARASOTA
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State | FL
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Zip | 34231-3606
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Country | US
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Telephone | 941-921-9936
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Fax | 941-922-2133
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Provider Business Mailing Address
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Address Line | 1819 GLENGARY ST
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City | SARASOTA
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State | FL
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Zip | 34231-3603
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Country | US
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Telephone | 941-921-9936
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Fax | 941-922-2133
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. WILLIAM KEVIN MCKEEVER
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Credential | MA, CRC
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Telephone | 941-921-9936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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