Healthcare Provider Details

I. General information

NPI: 1891449393
Provider Name (Legal Business Name): SONNY K SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6653 WALKER ST
MILTON FL
32570-6672
US

IV. Provider business mailing address

6653 WALKER ST
MILTON FL
32570-6672
US

V. Phone/Fax

Practice location:
  • Phone: 850-341-1742
  • Fax:
Mailing address:
  • Phone: 850-341-1742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY SLACK
Title or Position: OWNER
Credential:
Phone: 850-341-1742