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Organization

HABILITATIVE SERVICES OF NORTH FLORIDA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NATALIE HARDY (EXECUTIVE DIRECTOR)
(850) 482-5391
Entity
Organization

Contact information

Practice address
4440 PUTNAM ST, MARIANNA, FL 32446-3455
(850) 482-5391
(850) 482-2833
Mailing address
4440 PUTNAM ST, MARIANNA, FL 32446-3455
(850) 482-5391
(850) 482-2833

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
670805696
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
670805696
MEDICAID WAIVER PROVIDER
FL
Enumeration date
10/17/2013
Last updated
10/17/2013
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