Provider Demographics
NPI:1457418493
Name:CHILDREN'S HOME SOCIETY
Entity type:Organization
Organization Name:CHILDREN'S HOME SOCIETY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DYNITIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-921-0330
Mailing Address - Street 1:1801 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5433
Mailing Address - Country:US
Mailing Address - Phone:850-921-0330
Mailing Address - Fax:850-921-0283
Practice Address - Street 1:1801 MICCOSUKEE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5433
Practice Address - Country:US
Practice Address - Phone:850-921-0330
Practice Address - Fax:850-921-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management