Provider Demographics
NPI:1265731350
Name:FAMILY PRESERVATION SERVICES OF FLORIDA
Entity type:Organization
Organization Name:FAMILY PRESERVATION SERVICES OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TARGETED CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:TCM
Authorized Official - Phone:772-205-5562
Mailing Address - Street 1:519 CALAMONDIN WAY SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-6004
Mailing Address - Country:US
Mailing Address - Phone:772-205-5562
Mailing Address - Fax:
Practice Address - Street 1:519 CALAMONDIN WAY SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-6004
Practice Address - Country:US
Practice Address - Phone:772-205-5562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management