Provider Demographics
NPI:1356719207
Name:FAMILY ADVOCATES
Entity type:Organization
Organization Name:FAMILY ADVOCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-403-8145
Mailing Address - Street 1:2167 LAKE DEBRA DR
Mailing Address - Street 2:UNIT 738
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1221 W COLONIAL DR
Practice Address - Street 2:UNIT 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7163
Practice Address - Country:US
Practice Address - Phone:407-888-6888
Practice Address - Fax:407-250-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services