Healthcare Provider Details
I. General information
NPI: 1063365013
Provider Name (Legal Business Name): ANCHOR BRIDGE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7808 LAKESIDE WOODS DR
ORLANDO FL
32810-2927
US
IV. Provider business mailing address
4375 BERRY OAK DR
APOPKA FL
32712-5794
US
V. Phone/Fax
- Phone: 407-456-3444
- Fax:
- Phone: 407-456-3444
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEANIQUE
MICHELLE
JACQUES TUCKER
Title or Position: MANAGING MEMBER
Credential: RN
Phone: 407-456-3444