Healthcare Provider Details
I. General information
NPI: 1982477949
Provider Name (Legal Business Name): THE PLAYFUL FAMILY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2023
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
616 STATE ROAD 13 N STE 12
FRUIT COVE FL
32259-3868
US
IV. Provider business mailing address
616 STATE ROAD 13 N STE 12
FRUIT COVE FL
32259-3868
US
V. Phone/Fax
- Phone: 904-217-7384
- Fax:
- Phone: 904-217-7384
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANCHESCKA
KEPHART
Title or Position: CEO
Credential:
Phone: 904-615-7126