Easterseals Northeast Central Florida, Inc.
Organization Active NPI Behavior Analyst · Bunnell, FL
NPI 1831963131 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1831963131
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Analyst 103K00000X
- Legal business name
- EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
- Practice address
- 3389 N State St Unit 1
Bunnell, FL 32110-4340 - Phone
- (386) 255-4568
- Fax
- (386) 258-7677
- NPI assigned
- Nov 8, 2023
- Organization subpart
- No
Authorized official
- Name
- Michele Wallens
- Title
- Accounting Manager
- Phone
- (386) 255-4568
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Easter Seal Society
Locations
3389 N State St
Unit 1
Bunnell, FL 32110
Phone (386) 255-4568
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | Yes |
Addresses
Primary practice location
3389 N State St Unit 1
Bunnell, FL 32110-4340
Mailing address
1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone (386) 944-7805
Other names
- #MIP
Other providers in Bunnell, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.