Provider Demographics
NPI:1982048500
Name:UNITED CEREBRAL PALSY OF PALM BEACH & MID-COAST COUNTIES
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF PALM BEACH & MID-COAST COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, BCABA
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-357-7779
Mailing Address - Street 1:3595 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4027
Mailing Address - Country:US
Mailing Address - Phone:561-357-7779
Mailing Address - Fax:561-357-7796
Practice Address - Street 1:3595 2ND AVE N
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-4027
Practice Address - Country:US
Practice Address - Phone:561-357-7779
Practice Address - Fax:561-357-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL670034996Medicaid