Provider Demographics
NPI:1689009540
Name:JENNIFER SECOR
Entity Type:Organization
Organization Name:JENNIFER SECOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANANAGEMENT SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SECOR
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS HUMAN SERV
Authorized Official - Phone:321-632-8610
Mailing Address - Street 1:1845 COGSWELL ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3210
Mailing Address - Country:US
Mailing Address - Phone:321-632-8610
Mailing Address - Fax:321-639-5087
Practice Address - Street 1:1845 COGSWELL ST
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3210
Practice Address - Country:US
Practice Address - Phone:321-632-8610
Practice Address - Fax:321-639-5087
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREVARD ACHIEVEMENT CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management