Provider Demographics
NPI:1154503647
Name:THE DANIEL M. FOUNDATION, INC.
Entity Type:Organization
Organization Name:THE DANIEL M. FOUNDATION, INC.
Other - Org Name:CAMP HOLIDAY CHILDREN'S RESPITE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:STEVENS
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-426-0194
Mailing Address - Street 1:827 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-5045
Mailing Address - Country:US
Mailing Address - Phone:772-426-0194
Mailing Address - Fax:
Practice Address - Street 1:309 S 7TH ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4228
Practice Address - Country:US
Practice Address - Phone:772-426-0194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC15SL0110385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child