Healthcare Provider Details

I. General information

NPI: 1902342207
Provider Name (Legal Business Name): TAKE A BREAK BABYSITTING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 E COMANCHE AVE
TAMPA FL
33604-7226
US

IV. Provider business mailing address

1226 E COMANCHE AVE
TAMPA FL
33604-7226
US

V. Phone/Fax

Practice location:
  • Phone: 813-283-8224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SADE ANDREWS
Title or Position: OWNER
Credential: M.A.
Phone: 813-575-0822