Healthcare Provider Details

I. General information

NPI: 1770826018
Provider Name (Legal Business Name): SOLITA'S COMFORT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 04/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12195 SE 135TH AVE
OCKLAWAHA FL
32179-5241
US

IV. Provider business mailing address

12195 SE 135TH AVE
OCKLAWAHA FL
32179-5241
US

V. Phone/Fax

Practice location:
  • Phone: 352-288-0226
  • Fax: 352-288-5040
Mailing address:
  • Phone: 352-288-0226
  • Fax: 352-288-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberAL10918
License Number StateFL

VIII. Authorized Official

Name: SANDRA KAY MEECE
Title or Position: ADMINISTRATION
Credential:
Phone: 352-288-0226