Provider Demographics
NPI:1588049449
Name:EDOUARD & ASSOCIATES
Entity type:Organization
Organization Name:EDOUARD & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHENEKIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOUD
Authorized Official - Suffix:
Authorized Official - Credentials:FA, PA
Authorized Official - Phone:646-368-7436
Mailing Address - Street 1:4700 MILLENIA BLVD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:646-368-7436
Mailing Address - Fax:
Practice Address - Street 1:244 MADISON AVE
Practice Address - Street 2:SUITE 4870
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2817
Practice Address - Country:US
Practice Address - Phone:646-368-7436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities