Country Acres Group Home

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

18-1073-025-08 Issued in FL

Legal business name

COUNTRY ACRES GROUP HOME

Practice address

1850 S Deleon Ave
Titusville, FL 32780-7733

Phone

(321) 264-5000

Fax

(321) 264-5195

NPI assigned

Jun 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gay Williams

Title

Director Housing Human Services

Phone

(321) 264-5000

Specialties & licenses 1

Addresses

Tax ID family

Brevard County Board of County Commissioner2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brevard County Board of County Commissioner

  • Land Ambulance
  • Rockledge, FL
  • NPI 1194821595
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1730316688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S DELEON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807733",
            "telephone_number": "321-264-5000",
            "fax_number": "321-264-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S DELEON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807733",
            "telephone_number": "321-264-5000",
            "fax_number": "321-264-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY ACRES GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GAY",
        "authorized_official_title_or_position": "DIRECTOR HOUSING HUMAN SERVICES",
        "authorized_official_telephone_number": "321-264-5000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "FL",
            "license": "18-1073-025-08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Cornish
• Theresa Correa, ARNP
• Susanne Cortes-Morris, LCSW
• Emily D. Costello, NP
• Country Acres CH
• Country Club Dental Care
• Daphne C Courey, RPH
• Rebecca Christine Courtney, MA, BCBA
• Rebecca E Covert, LMT
• Ashley V Cox

• Foster Care Agency in Titusville, FL
• Providers in Titusville, FL by specialty
• Foster Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.