# SPACE COAST CENTER FOR INDEPENDENT LIVING

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

## Provider details

- **NPI number:** 1780913103
- **Authorized official:** JILL DUNHAM-CESARIO (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (321) 633-6011

## Contact information

- **Practice address:** 803 N FISKE BLVD, SUITE B, COCOA, FL 32922-7323
- **Practice address phone:** (321) 633-6011
- **Mailing address:** 803 N FISKE BLVD, SUITE B, COCOA, FL 32922-7323
- **Mailing address phone:** (321) 633-6011

## Taxonomy

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

## Other

- **Enumeration date:** 12/14/2009
- **Last updated:** 12/14/2009