Provider Demographics
NPI:1962178632
Name:ACADEMY AT GLENGARY, INC
Entity type:Organization
Organization Name:ACADEMY AT GLENGARY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:MCKEEVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CRC
Authorized Official - Phone:941-921-9936
Mailing Address - Street 1:1819 GLENGARY ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3603
Mailing Address - Country:US
Mailing Address - Phone:941-921-9936
Mailing Address - Fax:941-922-2133
Practice Address - Street 1:1910 GLENGARY ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3606
Practice Address - Country:US
Practice Address - Phone:941-921-9936
Practice Address - Fax:941-922-2133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health