Organization
G4S YOUTH SERVICES, LLC
Active
Other names
Polk Halfway House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KERRY L. KNOTT (CHIEF EXECUTIVE OFFICER)
(561) 691-6729
Entity
Organization
Contact information
Practice address
2145 BOB PHILLIPS RD, BARTOW, FL 33830-6700
(863) 519-5581
(863) 519-6603
Mailing address
4200 WACKENHUT DR, WEST PALM BEACH, FL 33410-4242
(561) 691-6610
(561) 691-6578
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0707546
—
FL
Enumeration date
10/15/2010
Last updated
10/15/2010
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