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General NPI Number Information
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NPI Number | 1962710152
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Entity Type | Organization
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Legal Business Name | PHYLLIS DUNCOMBE CHILDCARE AND FAMILY RESOURCE CENTER INC
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 11820 49TH ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-9159
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Country | US
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Telephone | 561-784-8540
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Fax | 561-784-8540
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Provider Business Mailing Address
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Address Line | 11820 49TH ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-9159
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Country | US
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Telephone | 561-784-8540
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Fax | 561-784-8540
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DONALD CECIL DUNCOMBE
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Credential |
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Telephone | 561-784-8540
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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 | 091149
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License Number State | FL
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