Provider Demographics
NPI:1669641015
Name:THE ITM GROUP
Entity Type:Organization
Organization Name:THE ITM GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ITP COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-379-2829
Mailing Address - Street 1:225 SW 7TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6459
Mailing Address - Country:US
Mailing Address - Phone:352-379-2829
Mailing Address - Fax:352-379-2843
Practice Address - Street 1:225 SW 7TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6459
Practice Address - Country:US
Practice Address - Phone:352-379-2829
Practice Address - Fax:352-379-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health