Provider Demographics
NPI:1083412357
Name:ORGANIZATION OF BUSSINESSMEN
Entity type:Organization
Organization Name:ORGANIZATION OF BUSSINESSMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ORGANIZATION
Authorized Official - Prefix:MR
Authorized Official - First Name:EFREN
Authorized Official - Middle Name:CERRONE
Authorized Official - Last Name:PALM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-320-3022
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:CHATTAHOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:32324-0033
Mailing Address - Country:US
Mailing Address - Phone:850-320-3200
Mailing Address - Fax:
Practice Address - Street 1:202 BOYKIN AVE
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-2007
Practice Address - Country:US
Practice Address - Phone:850-320-3022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Multi-Specialty