EXTENDED FAMILY ALR INC
Residential Treatment Facilities at Claudia St, New Smyrna, FL

License number
Florida AL12247
Category
Residential Treatment Facilities
Type
Residential Treatment Facility, Physical Disabilities
Owner
Name: MR. MATTHEW HAWKINS SR.
Title: PRESIDENT
Phone: (386) 957-3907
Address
Address 2
1020 Claudia St, New Smyrna, FL 32168
2505 W Lake Dr, Deland, FL 32724
National Provider ID: 1356764823
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EXTENDED FAMILY ALR INC

Daytona Beach, FL  -  Deland, FL

Status:
Inactive
Industry:
Individual/Family Services
Inactive reason:
AMENDMENT
Registration:
Nov 21, 2011
Inactive since:
Mar 9, 2012
Addresses:
666A Lpga Blvd, Daytona Beach, FL 32117 (Physical)
2505 W Lk Dr, Deland, FL 32724
666 Lpga Blvd, Daytona Beach, FL 32117
State ID:
N11000010843
Business type:
Florida Not For Profit Corporation
Chairman, Secretarys:
Matthew Hawkins (President), 666A Lpga Blvd, Daytona Beach, FL 32117 (Physical),Michele Marcus (Vice President), 2505 W Lk Dr, Deland, FL 32724 (Physical),Elvira D'emilio (Chairman, Secretary), 2505 W Lk Dr, Deland, FL 32724 (Physical)
Agent:
Hawkins, Matthew,666A Lpga Blvd, Daytona Beach, FL 32117 (Physical)
EIN:
453686811

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