Provider Demographics
NPI: | 1114359759 |
---|---|
Name: | AFTER COURT SOLUTIONS LLC |
Entity Type: | Organization |
Organization Name: | AFTER COURT SOLUTIONS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | LINDA |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | NAZARIO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | CERTIFIED ADDICTION |
Authorized Official - Phone: | 407-944-1155 |
Mailing Address - Street 1: | 120 BROADWAY |
Mailing Address - Street 2: | SUITE 206 |
Mailing Address - City: | KISSIMMEE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34741-5703 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-944-1155 |
Mailing Address - Fax: | 407-536-4348 |
Practice Address - Street 1: | 120 BROADWAY |
Practice Address - Street 2: | SUITE 206 |
Practice Address - City: | KISSIMMEE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34741-5703 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-944-1155 |
Practice Address - Fax: | 407-536-4348 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-08-06 |
Last Update Date: | 2013-08-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | CAP 3330 | 252Y00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 252Y00000X | Agencies | Early Intervention Provider Agency |