Healthcare Provider Details

I. General information

NPI: 1235879453
Provider Name (Legal Business Name): SDR HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10236 ALDER GREEN DR
RIVERVIEW FL
33578-6283
US

IV. Provider business mailing address

2801 2ND AVE S
ST PETERSBURG FL
33712-1003
US

V. Phone/Fax

Practice location:
  • Phone: 727-278-4014
  • Fax:
Mailing address:
  • Phone: 727-278-4014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREW REEVES FINKLEY
Title or Position: OWNER
Credential: RN, EMT-P
Phone: 727-278-4014