Organization
EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE WALLENS (ACCOUNTING MANAGER)
(386) 255-4568
Entity
Organization
Contact information
Practice address
650 W NEW YORK AVE, DELAND, FL 32720-5239
(386) 255-4568
(386) 258-7677
Mailing address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
(386) 258-7677
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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