Provider Demographics
NPI:1033371588
Name:H E R O E S EXPRESS INC
Entity Type:Organization
Organization Name:H E R O E S EXPRESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-689-1448
Mailing Address - Street 1:6188 WILKINSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-9137
Mailing Address - Country:US
Mailing Address - Phone:850-689-1448
Mailing Address - Fax:850-682-5560
Practice Address - Street 1:6188 WILKINSON DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-9137
Practice Address - Country:US
Practice Address - Phone:850-689-1448
Practice Address - Fax:850-682-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services