| Organization Name: | EASTER SEAL SOCIETY OF VOLUSIA AND FLAGLER |
| NPI Number: | 1649668351 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELE WALLENS (ACCOUNTING SUPERVISOR) |
| Mailing Address: | 1219 Dunn Ave Daytona Beach |
| State: | FL US |
| Postal Code: | 321142405 |
| Phone Number: | 3869447805 |
| Fax Number: | 3862587677 |
| NPI Enumeration Date: | 01/05/2015 |
| NPI Last Update Date: | 01/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |