Provider Demographics
NPI:1790486181
Name:PARENT RESOURCE GROUP OF FLORIDA
Entity Type:Organization
Organization Name:PARENT RESOURCE GROUP OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:904-910-7317
Mailing Address - Street 1:973 HUNTERS MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-6639
Mailing Address - Country:US
Mailing Address - Phone:904-705-4366
Mailing Address - Fax:
Practice Address - Street 1:7208 W SAND LAKE RD STE 305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5279
Practice Address - Country:US
Practice Address - Phone:904-910-7311
Practice Address - Fax:863-874-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty