Provider Demographics
NPI:1558408872
Name:NORTH EAST FLORIDA ADDICTIONS NETWORK
Entity Type:Organization
Organization Name:NORTH EAST FLORIDA ADDICTIONS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-527-8551
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32721-0694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3481 FOXTON CT
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5166
Practice Address - Country:US
Practice Address - Phone:386-527-8551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service