| Easterseals Northeast Central Florida, Inc. | |
|
1219 Dunn Ave Daytona Beach FL 32114-2405 | |
| (386) 944-7805 | |
| Not Available |
| Full Name | Easterseals Northeast Central Florida, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1219 Dunn Ave, Daytona Beach, Florida |
| Authorized Official Name and Position | Michele Wallens (ACCOUNTING MANAGER) |
| Authorized Official Contact | 3862554568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easterseals Northeast Central Florida, Inc. 1219 Dunn Ave Daytona Beach FL 32114-2405 Ph: (386) 944-7805 | Easterseals Northeast Central Florida, Inc. 1219 Dunn Ave Daytona Beach FL 32114-2405 Ph: (386) 944-7805 |
| NPI Number | 1164030532 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164030532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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