Organization
SPOLI CORP
Active
Organization
SPOLI CORP
Active
Parent organization
BETHESDA MANOR
Other names
Bethesda Manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
BETHESDA MANOR
Authorized official
PAM OLI (OWNER)
(386) 451-1245
Entity
Organization
Contact information
Practice address
1157 JOHN ANDERSON DR, ORMOND BEACH, FL 32176-4173
(386) 441-6045
Mailing address
1157 JOHN ANDERSON DR, ORMOND BEACH, FL 32176-4173
(386) 441-6045
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676245096
—
FL
Enumeration date
02/07/2022
Last updated
02/07/2022
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