Healthcare Provider Details

I. General information

NPI: 1154121598
Provider Name (Legal Business Name): CLASS AT LITTLE SPROUTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/23/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14806 NW 142ND TER
ALACHUA FL
32615-8572
US

IV. Provider business mailing address

18622 NW US HIGHWAY 441
HIGH SPRINGS FL
32643-8705
US

V. Phone/Fax

Practice location:
  • Phone: 352-224-9781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBEKKAH FAUL
Title or Position: OWNER
Credential:
Phone: 352-224-9781