Provider Demographics
NPI:1659793719
Name:FLAGLER COUNTY BOARD OF COUNTY COMMISSIONERS
Entity Type:Organization
Organization Name:FLAGLER COUNTY BOARD OF COUNTY COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-586-2324
Mailing Address - Street 1:1000 BELLE TERRE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5238
Mailing Address - Country:US
Mailing Address - Phone:386-586-2324
Mailing Address - Fax:386-437-7336
Practice Address - Street 1:1000 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5238
Practice Address - Country:US
Practice Address - Phone:386-586-2324
Practice Address - Fax:386-437-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8842251B00000X, 311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No251B00000XAgenciesCase Management