Provider Demographics
NPI:1548225782
Name:THE CENTER FOR INDEPENDENT LIVING OF NORTH FLORIDA
Entity type:Organization
Organization Name:THE CENTER FOR INDEPENDENT LIVING OF NORTH FLORIDA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PROGRAMS AND SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-575-9621
Mailing Address - Street 1:1823 BUFORD CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4465
Mailing Address - Country:US
Mailing Address - Phone:850-575-9621
Mailing Address - Fax:850-575-5740
Practice Address - Street 1:1823 BUFORD CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4465
Practice Address - Country:US
Practice Address - Phone:850-575-9621
Practice Address - Fax:850-575-5740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable