Provider Demographics
NPI:1033187471
Name:TWIN OAKS JUVENILE DEVELOPMENT
Entity Type:Organization
Organization Name:TWIN OAKS JUVENILE DEVELOPMENT
Other - Org Name:TWIN OAKS COMMUNITY SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:850-379-3973
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321
Mailing Address - Country:US
Mailing Address - Phone:850-643-1090
Mailing Address - Fax:
Practice Address - Street 1:29841 SW LIBERTY WILDERNESS CAMP ROAD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-0068
Practice Address - Country:US
Practice Address - Phone:850-643-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL858012660947C-2251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare