Provider Demographics
NPI:1184235855
Name:DEBBIEAS SUPPORT INC
Entity type:Organization
Organization Name:DEBBIEAS SUPPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALPHONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-237-5784
Mailing Address - Street 1:PO BOX 7946
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34985-7946
Mailing Address - Country:US
Mailing Address - Phone:772-237-5784
Mailing Address - Fax:
Practice Address - Street 1:710 SW JACOBY AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3955
Practice Address - Country:US
Practice Address - Phone:772-237-5784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty