Provider Demographics
NPI:1275863235
Name:FENN SYSTEMS INC.
Entity Type:Organization
Organization Name:FENN SYSTEMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:FENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-629-2883
Mailing Address - Street 1:1870 ALOMA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4050
Mailing Address - Country:US
Mailing Address - Phone:407-629-2883
Mailing Address - Fax:407-629-2883
Practice Address - Street 1:1870 ALOMA AVE STE 110
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4050
Practice Address - Country:US
Practice Address - Phone:407-629-2883
Practice Address - Fax:407-629-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9595104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty