Healthcare Provider Details

I. General information

NPI: 1619824299
Provider Name (Legal Business Name): GENTLE HORIZON HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 8TH AVE S
ST PETERSBURG FL
33711-1810
US

IV. Provider business mailing address

4760 8TH AVE S
ST PETERSBURG FL
33711-1810
US

V. Phone/Fax

Practice location:
  • Phone: 727-321-7446
  • Fax: 727-321-7446
Mailing address:
  • Phone: 727-321-7446
  • Fax: 727-321-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number StateNULL

VIII. Authorized Official

Name: RIDEJA BLANCHARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 727-600-6097