Organization
FAMILY ADVOCATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK TARIQ COLLINS EL M.S.W (TARGETED CASE MANAGER POSITION)
(407) 319-4498
Entity
Organization
Contact information
Practice address
767 W GRANADA BLVD, ORMOND BEACH, FL 32174-9441
(407) 319-4498
Mailing address
767 W GRANADA BLVD, ORMOND BEACH, FL 32174-9441
(407) 319-4498
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010459700
—
FL
Enumeration date
07/16/2014
Last updated
07/16/2014
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