Provider Demographics
NPI:1487188058
Name:PROJECT RESPONSE, INC.
Entity Type:Organization
Organization Name:PROJECT RESPONSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HACKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-724-1177
Mailing Address - Street 1:745 S. APOLLO BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901
Mailing Address - Country:US
Mailing Address - Phone:321-724-1177
Mailing Address - Fax:321-724-2255
Practice Address - Street 1:747 S. APOLLO BOULEVARD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-372-5003
Practice Address - Fax:321-345-5671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QC1500X
261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health