Provider Demographics
NPI:1649221011
Name:TWIN OAKS JUVENILE DEVELOPMENT, INC
Entity Type:Organization
Organization Name:TWIN OAKS JUVENILE DEVELOPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:READ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-643-1090
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321-0068
Mailing Address - Country:US
Mailing Address - Phone:850-643-1090
Mailing Address - Fax:850-643-1091
Practice Address - Street 1:11939 NW STATE ROAD 20
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-3416
Practice Address - Country:US
Practice Address - Phone:850-643-1090
Practice Address - Fax:850-643-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty