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EBEN-EZER GROUP HOME NPI 1588956320


NPI Information

NPI: 1588956320
Provider Name: EBEN-EZER GROUP HOME

Doing Business As: NONE

Classification: Respite Care - 385HR2060X
Entity Type: Organization

Specialization: Respite Care, Intellectual and/or Developmental Disabilities

Address:
1688 SW BURLINGTON ST
PORT ST LUCIE, FL
ZIP 34984
Phone: (772) 240-6636
Get Directions

EBEN-EZER GROUP HOME is a respite care and mental retardation and/or developmental disabilities respite care in Port St Lucie, FL. The provider is a facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers. EBEN-EZER GROUP HOME NPI is 1588956320. The provider is registered as an organization entity type.
The provider Is Doing Business As None.

The provider's business location address is:

1688 SW BURLINGTON ST
PORT ST LUCIE, FL
ZIP 34984-559
Phone: (772) 240-6636
Fax: (772) 249-7004

The provider's authorized official is Eveline Charles .
The authorized official title is Administrator/owner and has the following contact phone number (772) 240-6636.

The enumeration date for this NPI number is 5/12/2011 and was last updated on 5/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1385HR2060XRespite CareRespite Care, Intellectual and/or Developmental Disabilities151427FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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