Provider Demographics
NPI:1821256231
Name:COOPERATIVE ADVENTURES, INC.
Entity Type:Organization
Organization Name:COOPERATIVE ADVENTURES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GWENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-384-0909
Mailing Address - Street 1:1208 NW 6TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4245
Mailing Address - Country:US
Mailing Address - Phone:352-384-0909
Mailing Address - Fax:352-384-1752
Practice Address - Street 1:1208 NW 6TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4245
Practice Address - Country:US
Practice Address - Phone:352-384-0909
Practice Address - Fax:352-384-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services