Organization
BREVARD ALZHEIMER'S FOUNDATION INC.
Active
Other names
Joe's Club
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY VICTOR TIMMEMANN (EXECUTIVE DIRECTOR)
(321) 253-4430
Entity
Organization
Contact information
Practice address
830 S PARK AVE, TITUSVILLE, FL 32780-4000
(321) 253-4430
(321) 253-1993
Mailing address
4676 N WICKHAM RD, MELBOURNE, FL 32935-7103
(321) 253-4430
(321) 253-1993
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104835401
—
FL
Enumeration date
08/19/2021
Last updated
08/19/2021
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