OrganizationActive
College Internship Program, Inc.
NPI 1679736656 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Melbourne, FL
Provider details
- NPI number
- 1679736656
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Carol Bernard, Bookkeeper(321) 259-1900
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3716 N Wickham Rd
Suite 1
Melbourne, FL 32935-2324
Phone: (321) 259-1900
Fax: (321) 259-1907
Street-level locationGet directions
Mailing address
3716 N Wickham Rd
Melbourne, FL 32935-2324
Registry dates
- Enumerated
- 2008-07-09
- Last updated
- 2008-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.