Healthcare Provider Details

I. General information

NPI: 1942990197
Provider Name (Legal Business Name): THRIVING OUTLOOK FOR PROSPERING SENIORS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 LAKE HARRIS DR
TAVARES FL
32778-4102
US

IV. Provider business mailing address

2578 LIMERICK CIR
GRAND ISLAND FL
32735-9006
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-9025
  • Fax: 352-818-4476
Mailing address:
  • Phone: 352-870-3439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. NICHOLE BLAKE-LITTLE
Title or Position: OPERATOR
Credential: RN
Phone: 352-870-3439