Provider Demographics
NPI:1114065943
Name:RESIDENTIAL CRF, INC
Entity Type:Organization
Organization Name:RESIDENTIAL CRF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-827-6996
Mailing Address - Street 1:700 W 23RD ST
Mailing Address - Street 2:SUITE 52
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3936
Mailing Address - Country:US
Mailing Address - Phone:850-785-0605
Mailing Address - Fax:850-785-8061
Practice Address - Street 1:2603 STATE AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4359
Practice Address - Country:US
Practice Address - Phone:850-785-0605
Practice Address - Fax:850-785-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities