| Emerald Coast Autism Center | |
|
315 Edge Ave Valparaiso FL 32580-1807 | |
| (850) 279-3000 | |
| (850) 389-2269 |
| Full Name | Emerald Coast Autism Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 315 Edge Ave, Valparaiso, Florida |
| Authorized Official Name and Position | Staci Berryman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8502793000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Autism Center 315 Edge Ave Valparaiso FL 32580-1807 Ph: (850) 279-3000 | Emerald Coast Autism Center 315 Edge Ave Valparaiso FL 32580-1807 Ph: (850) 279-3000 |
| NPI Number | 1255715074 |
|---|---|
| Provider Enumeration Date | 07/10/2015 |
| Last Update Date | 07/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255715074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 11518965 (Florida) | Primary |
Emerald Coast Autism Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Edge Ave, Valparaiso, FL 32580 Phone: 850-279-3000 Fax: 850-389-2269 |