Healthcare Provider Details

I. General information

NPI: 1316106909
Provider Name (Legal Business Name): HELP IS ON THE WAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 GILMORE AVENUE
LAKELAND FL
33801
US

IV. Provider business mailing address

721 GILMORE AVENUE
LAKELAND FL
33801
US

V. Phone/Fax

Practice location:
  • Phone: 863-682-6374
  • Fax: 775-361-2175
Mailing address:
  • Phone: 863-682-6374
  • Fax: 775-361-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number14GH01134
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number14GH01134
License Number StateFL

VIII. Authorized Official

Name: MR. SAMUEL RANARD COOPER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 863-682-6374