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General NPI Number Information
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NPI Number | 1962549659
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Entity Type | Organization
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Legal Business Name | NORTHWEST FLORIDA COMPREHENSIVE SERVICES FOR CHILDREN, INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 3401 N 12TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32503-4008
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Country | US
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Telephone | 850-595-5810
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Fax | 850-595-5813
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Provider Business Mailing Address
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Address Line | 4400 BAYOU BLVD SUITE #46
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City | PENSACOLA
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State | FL
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Zip | 32503-2673
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Country | US
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Telephone | 850-474-3696
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Fax | 850-474-4170
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CATHERINE JORDAN
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Credential |
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Telephone | 850-474-3696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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