Provider Demographics
NPI:1912271677
Name:CHARLOTTE COUNTY HEAD START
Entity Type:Organization
Organization Name:CHARLOTTE COUNTY HEAD START
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY SERVICE WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-575-5470
Mailing Address - Street 1:311 E CHARLOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4905
Mailing Address - Country:US
Mailing Address - Phone:941-575-5470
Mailing Address - Fax:941-575-5474
Practice Address - Street 1:311 E CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4905
Practice Address - Country:US
Practice Address - Phone:941-575-5470
Practice Address - Fax:941-575-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363LS0200X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management