Provider Demographics
NPI:1952665648
Name:PERSEVERANCE PROJECT, LLC
Entity Type:Organization
Organization Name:PERSEVERANCE PROJECT, LLC
Other - Org Name:JL JOHNSON CONSULTING, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-264-3737
Mailing Address - Street 1:7138 ATASCADERO LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-7460
Mailing Address - Country:US
Mailing Address - Phone:850-270-2246
Mailing Address - Fax:850-391-7693
Practice Address - Street 1:7138 ATASCADERO LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32317-7460
Practice Address - Country:US
Practice Address - Phone:850-270-2246
Practice Address - Fax:850-391-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health