Provider Demographics
NPI:1437448560
Name:INTERFAITH HUMANITARIAN SERVICES INC
Entity Type:Organization
Organization Name:INTERFAITH HUMANITARIAN SERVICES INC
Other - Org Name:FAMILY ADVOCATES OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-437-2034
Mailing Address - Street 1:7065 WESTPOINTE BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8757
Mailing Address - Country:US
Mailing Address - Phone:407-532-9000
Mailing Address - Fax:
Practice Address - Street 1:7065 WESTPOINTE BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8757
Practice Address - Country:US
Practice Address - Phone:407-532-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health