Organization
COMMUNITY RESOURCE NETWORK OF FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JEROME (DIRECTOR OF OPERATIONS)
(239) 247-2041
Entity
Organization
Contact information
Practice address
12751 WORLD PLAZA LN, FORT MYERS, FL 33907-3989
(239) 415-7400
(239) 236-0236
Mailing address
12751 WORLD PLAZA LN, FORT MYERS, FL 33907-3989
(239) 415-7400
(239) 236-0236
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
347B00000X
Bus
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104234600
—
FL
Enumeration date
04/18/2011
Last updated
10/26/2022
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