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Organization
SPACE COAST CENTER FOR INDEPENDENT LIVING
Active
Organization
SPACE COAST CENTER FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL DUNHAM-CESARIO (EXECUTIVE DIRECTOR)
(321) 633-6011
Entity
Organization
Contact information
Practice address
803 N FISKE BLVD, SUITE B, COCOA, FL 32922-7323
(321) 633-6011
Mailing address
803 N FISKE BLVD, SUITE B, COCOA, FL 32922-7323
(321) 633-6011
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
12/14/2009
Last updated
12/14/2009
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