Provider Demographics
NPI:1043957426
Name:FRIENDS THAT CARE, LLC
Entity Type:Organization
Organization Name:FRIENDS THAT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-914-9245
Mailing Address - Street 1:8530 N WICKHAM RD STE 112
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6616
Mailing Address - Country:US
Mailing Address - Phone:321-914-9245
Mailing Address - Fax:
Practice Address - Street 1:8530 N WICKHAM RD STE 112
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6616
Practice Address - Country:US
Practice Address - Phone:321-914-9245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities