Provider Demographics
NPI:1508007899
Name:GAINESVILLE OPPORTUNITY CENTER
Entity Type:Organization
Organization Name:GAINESVILLE OPPORTUNITY CENTER
Other - Org Name:GOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-224-5523
Mailing Address - Street 1:1717 NE 9TH ST
Mailing Address - Street 2:BUILDING A, SUITE 140
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3797
Mailing Address - Country:US
Mailing Address - Phone:352-224-5523
Mailing Address - Fax:352-224-5555
Practice Address - Street 1:1717 NE 9TH ST
Practice Address - Street 2:BUILDING A, SUITE 140
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3797
Practice Address - Country:US
Practice Address - Phone:352-224-5523
Practice Address - Fax:352-224-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health