# SPACE COAST CENTER FOR INDEPENDENT LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528326758
- **Authorized official:** JILL L DUNHAM-SCHULLER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (321) 633-6011

## Contact information

- **Practice address:** 571 HAVERTY CT STE W, ROCKLEDGE, FL 32955-3614
- **Practice address phone:** (321) 633-6011
- **Practice address fax:** (321) 633-6472
- **Mailing address:** 571 HAVERTY CT STE W, ROCKLEDGE, FL 32955-3614
- **Mailing address phone:** (321) 633-6011
- **Mailing address fax:** (321) 633-6472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/25/2012
- **Last updated:** 04/25/2012