Provider Demographics
NPI:1356883672
Name:FIFTH CIRCUIT PULIC GUARDIAN CORP.
Entity type:Organization
Organization Name:FIFTH CIRCUIT PULIC GUARDIAN CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-401-6753
Mailing Address - Street 1:P.O. BOX 4985
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478
Mailing Address - Country:US
Mailing Address - Phone:352-401-6753
Mailing Address - Fax:352-401-7803
Practice Address - Street 1:110 NW 1ST ST
Practice Address - Street 2:COURTHOUSE
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475
Practice Address - Country:US
Practice Address - Phone:352-401-6753
Practice Address - Fax:352-401-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management