Provider Demographics
NPI:1366697138
Name:GAY, LESBIAN, BISEXUAL COMMUNITY CENTER OF CENTRAL FLORIDA
Entity type:Organization
Organization Name:GAY, LESBIAN, BISEXUAL COMMUNITY CENTER OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:407-228-8272
Mailing Address - Street 1:946 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3230
Mailing Address - Country:US
Mailing Address - Phone:407-228-8272
Mailing Address - Fax:
Practice Address - Street 1:946 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3230
Practice Address - Country:US
Practice Address - Phone:407-228-8272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable