Healthcare Provider Details

I. General information

NPI: 1194216127
Provider Name (Legal Business Name): ENDLESS ABILITIES FOR CHILDREN WITH DISABILITIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 S LB BROWN AVE
BARTOW FL
33830-4901
US

IV. Provider business mailing address

PO BOX 1712
BARTOW FL
33831-1712
US

V. Phone/Fax

Practice location:
  • Phone: 863-205-1624
  • Fax: 863-537-6135
Mailing address:
  • Phone: 863-205-1624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RESHEKA HARRIS
Title or Position: CEO
Credential:
Phone: 863-205-1624