NPI 1356764823

Extended Family Alr INC

Organisation Physical Disabilities Residential Treatment Facility New Smyrna Beach, FL

Practice location

Address: 1020 Claudia St, New Smyrna Beach, FL 32168-6354
Phone: (386) 957-3907
Fax: (386) 957-6316
Mailing address: 2505 W Lake Dr, Deland, FL 32724-3245

Authorised official

Name: Matthew Hawkins
Title: President
Phone: (386) 957-3907

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence AL12247 (FL)

Other Residential Treatment Facility, Physical Disabilities providers in Florida →

Registry record

NPI: 1356764823
Entity type: Organization
NPI issued: 3 Feb 2014
Record last updated: 3 Feb 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.