Organization
EXTENDED FAMILY ALR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW HAWKINS SR. (PRESIDENT)
(386) 957-3907
Entity
Organization
Contact information
Practice address
1020 CLAUDIA ST, NEW SMYRNA BEACH, FL 32168-6354
(386) 957-3907
(386) 957-6316
Mailing address
2505 W LAKE DR, DELAND, FL 32724-3245
(386) 957-3907
(386) 957-6316
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
AL12247
FL
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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