Healthcare Provider Details

I. General information

NPI: 1891102711
Provider Name (Legal Business Name): THE FAMILY ENRICHMENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5407 N 30TH ST
TAMPA FL
33610-4414
US

IV. Provider business mailing address

1002 E. DR.MARTIN LUTHER KING BLVD.
TAMPA FL
33603
US

V. Phone/Fax

Practice location:
  • Phone: 813-232-9659
  • Fax: 813-231-7196
Mailing address:
  • Phone: 813-237-2530
  • Fax: 813-231-7196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9282
License Number StateFL

VIII. Authorized Official

Name: MS. OLGA STIRRUP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 813-237-2530