Organization Name: | PPCC, INC. |
NPI Number: | 1164747739 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN M PAGE (PRESIDENT) |
Mailing Address: | 259 E Oakdale Ave Crestview |
State: | FL US |
Postal Code: | 325393547 |
Phone Number: | 8503985255 |
Fax Number: | 8506898799 |
NPI Enumeration Date: | 04/07/2010 |
NPI Last Update Date: | 04/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH3313 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |