| Easter Seals Florida, Inc. | |
|
2100 Se Hillmoor Dr Ste 104 Port St Lucie FL 34952-8057 | |
| (772) 380-9972 | |
| (772) 380-9976 |
| Full Name | Easter Seals Florida, Inc. |
|---|---|
| Speciality | Case Management |
| Location | 2100 Se Hillmoor Dr Ste 104, Port St Lucie, Florida |
| Authorized Official Name and Position | Rikesha Blake (CFO) |
| Authorized Official Contact | 4076297881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Florida, Inc. 2010 Crosby Way Winter Park FL 32792-4119 Ph: (407) 629-7881 | Easter Seals Florida, Inc. 2100 Se Hillmoor Dr Ste 104 Port St Lucie FL 34952-8057 Ph: (772) 380-9972 |
| NPI Number | 1134245889 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 11/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134245889 | NPI | - | NPPES |
| 111666600 | Medicaid | FL | |
| 892255102 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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