Organization
COMMUNITY-BASED OPTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN FREDERICK LORD JR. M.S.W (CEO/PRESIDENT)
(850) 249-6195
Entity
Organization
Contact information
Practice address
435 W OAK AVE, PANAMA CITY, FL 32401-2737
(850) 215-7688
(850) 769-2088
Mailing address
PO BOX 438, PANAMA CITY, FL 32402-0438
(850) 215-7688
(850) 769-2088
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686106796
—
FL
Enumeration date
05/31/2008
Last updated
05/31/2008
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