Space Coast Center for Independent Living

NPI #1780913103 in Cocoa, Florida

Provider Information

NPI Number: 1780913103
Entity Type: Organization
Organization Name: Space Coast Center for Independent Living
Primary Specialty: Case Management
Enumeration Date: Dec 14, 2009
Last Updated: Dec 14, 2009

Practice Location

Address: 803 N FISKE BLVD
Address 2: SUITE B
City: Cocoa
State: Florida
ZIP Code: 32922-7323
Phone: (321) 633-6011

Authorized Official

Name: JILL DUNHAM-CESARIO
Title: EXECUTIVE DIRECTOR
Phone: (321) 633-6011

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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