Healthcare Provider Details

I. General information

NPI: 1669238119
Provider Name (Legal Business Name): GENCARE KIDS PPEC PLUS LEARNING CENTER KISSIMMEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E IRLO BRONSON MEMORIAL HWY
KISSIMMEE FL
34744-4993
US

IV. Provider business mailing address

2555 E IRLO BRONSON MEMORIAL HWY
KISSIMMEE FL
34744-4993
US

V. Phone/Fax

Practice location:
  • Phone: 888-425-7732
  • Fax:
Mailing address:
  • Phone: 888-425-7732
  • Fax: 407-440-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number State

VIII. Authorized Official

Name: OLIVE V GAYE
Title or Position: CEO/PRESIDENT
Credential:
Phone: 407-440-2877