Organization
SANTA ROSA COUNTY SCHOOL BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERICK C. GRACEY (DIRECTOR STUDENT SERVICES)
(850) 983-5587
Entity
Organization
Contact information
Practice address
6751 BERRYHILL ST, MILTON, FL 32570-4790
(850) 983-5151
Mailing address
6571 BERRYHILL, MILTON, FL 32570
(850) 983-5151
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081005301
—
FL
Enumeration date
12/20/2006
Last updated
01/29/2009
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