Provider Demographics
NPI:1225183114
Name:UNITED CEREBRAL PALSY OF N FLORIDA
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF N FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-769-7960
Mailing Address - Street 1:1241 N EAST AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-4426
Mailing Address - Country:US
Mailing Address - Phone:850-769-7960
Mailing Address - Fax:850-769-1060
Practice Address - Street 1:1241 N EAST AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-4426
Practice Address - Country:US
Practice Address - Phone:850-769-7960
Practice Address - Fax:850-769-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services