Healthcare Provider Details

I. General information

NPI: 1811317225
Provider Name (Legal Business Name): VETERAN'S TRANSITIONAL HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 PRINCESS ST
CLEARWATER FL
33755-1730
US

IV. Provider business mailing address

8875 HIDDEN RIVER PARKWAY
TAMPA FL
33637
US

V. Phone/Fax

Practice location:
  • Phone: 813-922-2838
  • Fax:
Mailing address:
  • Phone: 813-922-2838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. TINA MARIE WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 813-922-2838