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General NPI Number Information
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NPI Number | 1003358391
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Entity Type | Organization
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Legal Business Name | BRENDA LEES BEGIN AGAIN INC
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Dates
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Enumeration Date | 11/17/2016
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 5785 61ST ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709-1859
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Country | US
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Telephone | 727-873-8154
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 553
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City | PINELLAS PARK
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State | FL
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Zip | 33780-0553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BRENDA MCCOLISTER
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Credential |
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Telephone | 727-873-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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