Provider Demographics
NPI:1245416577
Name:CENTER FOR GLOBAL HEALTH & HUMANITY SERVICES
Entity Type:Organization
Organization Name:CENTER FOR GLOBAL HEALTH & HUMANITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:UKPONG
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:772-446-0389
Mailing Address - Street 1:1721 SW GLORIA LN
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1554
Mailing Address - Country:US
Mailing Address - Phone:772-446-0389
Mailing Address - Fax:
Practice Address - Street 1:1721 SW GLORIA LN
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-1554
Practice Address - Country:US
Practice Address - Phone:772-446-0389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN05000007078133NN1002X, 291U00000X, 302F00000X, 320800000X, 324500000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies