Provider Demographics
NPI:1073617155
Name:COPE CENTER, INC
Entity Type:Organization
Organization Name:COPE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPREHENSIVE ASSESSOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STULZAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-218-3532
Mailing Address - Street 1:103 PINEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-3323
Mailing Address - Country:US
Mailing Address - Phone:850-218-3532
Mailing Address - Fax:
Practice Address - Street 1:103 PINEHAVEN DR
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-3323
Practice Address - Country:US
Practice Address - Phone:850-218-3532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 36211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766724800Medicaid