Provider Demographics
NPI:1417385998
Name:FROM CHAINS TO GLORY ENTERPRISE
Entity Type:Organization
Organization Name:FROM CHAINS TO GLORY ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOZIER-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:202-497-5633
Mailing Address - Street 1:1363 AKRON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-4274
Mailing Address - Country:US
Mailing Address - Phone:202-497-5633
Mailing Address - Fax:
Practice Address - Street 1:1363 AKRON OAKS DR
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-4274
Practice Address - Country:US
Practice Address - Phone:202-497-5633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW114171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty