| Organization Name: | SANTA ROSA COUNTY SCHOOL BOARD |
| NPI Number: | 1013078104 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODERICK C. GRACEY (DIRECTOR STUDENT SERVICES) |
| Mailing Address: | 6751 Berryhill St Milton |
| State: | FL US |
| Postal Code: | 325704790 |
| Phone Number: | 8509835151 |
| Fax Number: | 8509835577 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |