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General NPI Number Information
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NPI Number | 1114854072
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Entity Type | Organization
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Legal Business Name | ROOTED LIFE CARE LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 8730 N HIMES AVE APT 1010
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City | TAMPA
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State | FL
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Zip | 33614-8306
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Country | US
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Telephone | 813-519-2851
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27005
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City | TAMPA
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State | FL
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Zip | 33623-7005
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Country | US
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Telephone | 813-519-2851
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIJAH SIEARRA SLAUGHTER
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Credential |
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Telephone | 813-519-2851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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