Provider Demographics
NPI:1306228317
Name:DEAF AND HARD OF HEARING SERVICES OF THE EMERALD COAST, INC.
Entity Type:Organization
Organization Name:DEAF AND HARD OF HEARING SERVICES OF THE EMERALD COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-607-8453
Mailing Address - Street 1:7100 PLANTATION RD
Mailing Address - Street 2:SUITE #11
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4206
Mailing Address - Country:US
Mailing Address - Phone:850-607-8453
Mailing Address - Fax:850-607-6935
Practice Address - Street 1:7100 PLANTATION RD
Practice Address - Street 2:SUITE #11
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4206
Practice Address - Country:US
Practice Address - Phone:850-607-8453
Practice Address - Fax:850-607-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 105461041C0700X
FLSA 10241235Z00000X
FL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty