Provider Demographics
NPI:1699917526
Name:PARENT CHILD CENTER, INC
Entity type:Organization
Organization Name:PARENT CHILD CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0-5 THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:561-841-3500
Mailing Address - Street 1:2001 W BLUE HERON BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-5003
Mailing Address - Country:US
Mailing Address - Phone:561-841-3500
Mailing Address - Fax:561-841-3555
Practice Address - Street 1:2001 W BLUE HERON BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-5003
Practice Address - Country:US
Practice Address - Phone:561-841-3500
Practice Address - Fax:561-841-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health