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NPI Code Detail

MEDICARE: GIVE BACK 2 KID INC

MEDICARE: GIVE BACK 2 KID INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2261QD1600XDevelopmental Disabilities Clinic/Center
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1598340234
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIVE BACK 2 KID INC
Provider Business Mailing Address
First Line : 945 BENT CREEK DR
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-1331
Country : US
Telephone Number : 321-456-7056
Fax Number :
Provider Business Practice Location Address
First Line : 820 SOLTMAN AVE
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-6504
Country : US
Telephone Number : 321-456-7056
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR/OWNER
Name : MR. JAMES ANTHONY MONDS JR.
Credential : M.ED.
Telephone Number : 321-456-7056
Provider Enumeration Date : 03/15/2021
Last Update Date : 03/15/2021

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Directions to “GIVE BACK 2 KID INC ” Practice Location

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