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General NPI Number Information
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NPI Number | 1124490099
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Entity Type | Organization
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Legal Business Name | SHANEE TOTAL CARE OF ASSISTANCE
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 41 W 13TH ST
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City | APOPKA
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State | FL
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Zip | 32703-6333
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Country | US
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Telephone | 407-312-3925
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Fax | 407-703-3480
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Provider Business Mailing Address
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Address Line | 41 W 13TH ST
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City | APOPKA
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State | FL
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Zip | 32703-6333
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Country | US
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Telephone | 407-312-3925
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Fax | 407-703-3480
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Authorized Official
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Title or Position | SOLE PROPRIETORSHIP
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Name | SHANEE TAYLOR
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Credential |
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Telephone | 407-312-3925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | FL
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