Organization
BREVARD ACHIEVEMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN RICHARD ROGERS (VICE PRESIDENT, ADMINISTRATION)
(321) 632-8610
Entity
Organization
Contact information
Practice address
1845 COGSWELL STREET, ROCKLEDGE, FL 32955
(321) 632-8610
(321) 639-5087
Mailing address
1845 COGSWELL STREET, ROCKLEDGE, FL 32955
(321) 632-8610
(321) 639-5087
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024163601
—
FL
05
—
024163696
—
FL
Enumeration date
10/22/2010
Last updated
10/28/2010
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