Organization
EDWARDS-EBANKS RESIDENTIAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNA EBANKS (MGR)
(561) 459-0578
Entity
Organization
Contact information
Practice address
710 43RD ST, WEST PALM BEACH, FL 33407-3851
(561) 459-0578
Mailing address
2264 SW MANELE PL, PALM CITY, FL 34990-8817
(561) 459-0578
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/16/2016
Last updated
05/08/2017
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