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General NPI Number Information
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NPI Number | 1366253320
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Entity Type | Organization
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Legal Business Name | ALTAMESE MCQUAY FOUNDATION INC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 3112 E IDA ST
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City | TAMPA
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State | FL
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Zip | 33610-7841
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Country | US
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Telephone | 909-919-4397
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Fax |
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Provider Business Mailing Address
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Address Line | 20125 OUTPOST POINT DR
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City | TAMPA
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State | FL
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Zip | 33647-3562
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Country | US
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Telephone | 909-919-4397
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHN MITCHELL
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Credential |
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Telephone | 909-919-4397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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