Provider Demographics
NPI:1144269036
Name:NEIGHBOR TO FAMILY, INC
Entity type:Organization
Organization Name:NEIGHBOR TO FAMILY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LLD,MED
Authorized Official - Phone:386-523-1440
Mailing Address - Street 1:220 S RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4393
Mailing Address - Country:US
Mailing Address - Phone:386-523-1440
Mailing Address - Fax:386-523-1459
Practice Address - Street 1:150 S PALMETTO AVE
Practice Address - Street 2:BOX R SUITE 200
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4385
Practice Address - Country:US
Practice Address - Phone:386-248-0712
Practice Address - Fax:386-248-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health