Provider Demographics
NPI:1871625764
Name:ADEPT SUPPORT COORDINATION
Entity type:Organization
Organization Name:ADEPT SUPPORT COORDINATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ETELKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FROYMOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-471-0740
Mailing Address - Street 1:7750 N MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2324
Mailing Address - Country:US
Mailing Address - Phone:317-471-0740
Mailing Address - Fax:317-471-0755
Practice Address - Street 1:1225 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601
Practice Address - Country:US
Practice Address - Phone:352-378-1492
Practice Address - Fax:352-378-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management