Provider Demographics
NPI:1851312946
Name:COURT EDUCATIONAL PROGRAMS
Entity type:Organization
Organization Name:COURT EDUCATIONAL PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:HERBST
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CCJAP
Authorized Official - Phone:352-343-9399
Mailing Address - Street 1:220 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-3808
Mailing Address - Country:US
Mailing Address - Phone:352-343-9399
Mailing Address - Fax:352-343-8881
Practice Address - Street 1:220 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3808
Practice Address - Country:US
Practice Address - Phone:352-343-9399
Practice Address - Fax:352-343-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1335AD6368101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty