Provider Demographics
NPI:1740302181
Name:FRIENDS OF ACCORD, INC
Entity type:Organization
Organization Name:FRIENDS OF ACCORD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-721-9210
Mailing Address - Street 1:150 S PALMETTO AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4385
Mailing Address - Country:US
Mailing Address - Phone:386-675-4694
Mailing Address - Fax:888-217-4124
Practice Address - Street 1:150 S PALMETTO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4385
Practice Address - Country:US
Practice Address - Phone:386-675-4694
Practice Address - Fax:888-217-4124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)