Healthcare Provider Details

I. General information

NPI: 1063830990
Provider Name (Legal Business Name): NEW PERCEPTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W CALL ST
STARKE FL
32091-3211
US

IV. Provider business mailing address

104 W CALL ST
STARKE FL
32091-3211
US

V. Phone/Fax

Practice location:
  • Phone: 904-966-2100
  • Fax: 904-966-2101
Mailing address:
  • Phone: 904-966-2100
  • Fax: 904-966-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number002209100
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number002209100
License Number StateFL

VIII. Authorized Official

Name: TINA HUTCHINS
Title or Position: DIRECTOR
Credential:
Phone: 904-966-2100