Organization
STEVE EWALD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE EWALD BS/MS (CEO)
(321) 505-7620
Entity
Organization
Contact information
Practice address
5595 WILLOUGHBY DR, MELBOURNE, FL 32934-2822
(321) 505-7620
Mailing address
5595 WILLOUGHBY DR, MELBOURNE, FL 32934-2822
(321) 505-7620
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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