Organization
EXCHANGE CLUB CENTER FOR PREVENTION OF CHILD ABUSE OF THE SPACE COAST
Active
Other names
Yellow Umbrella
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALETHEA M KLUVER-WILLIAMS LCSW (CLINICAL DIRECTOR)
(321) 914-9971
Entity
Organization
Contact information
Practice address
4680 LIPSCOMB ST NE, SUITE 10A, PALM BAY, FL 32905-2984
(321) 723-2927
(321) 723-2928
Mailing address
4680 LIPSCOMB ST NE, SUITE 10A, PALM BAY, FL 32905-2984
(321) 723-2927
(321) 723-2928
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
MH2142
FL
251S00000X
Community/Behavioral Health Agency
Primary
MH2142
FL
252Y00000X
Early Intervention Provider Agency
MH2142
FL
253Z00000X
In Home Supportive Care Agency
MH2142
FL
Other
Enumeration date
11/11/2011
Last updated
06/15/2015
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