Provider Demographics
NPI:1134818362
Name:TIME 2 LAUNCH INC
Entity type:Organization
Organization Name:TIME 2 LAUNCH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO, CHIEF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-247-9453
Mailing Address - Street 1:3832 SW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5631
Mailing Address - Country:US
Mailing Address - Phone:262-707-3257
Mailing Address - Fax:954-838-5358
Practice Address - Street 1:3832 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5631
Practice Address - Country:US
Practice Address - Phone:262-707-3257
Practice Address - Fax:954-838-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003245829AMedicaid
FL103590400Medicaid
FL023138100Medicaid