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General NPI Number Information
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NPI Number | 1497302681
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Entity Type | Organization
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Legal Business Name | SAFETY HARBOR ADULT DAY CARE & ACTIVITY CENTER LLC
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 3311 N POWERS DR
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City | ORLANDO
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State | FL
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Zip | 32818-2242
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Country | US
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Telephone | 407-496-8869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 683216
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City | ORLANDO
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State | FL
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Zip | 32868-3216
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Country | US
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Telephone | 407-496-8869
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JASCINTH BROCKINGTON
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Credential | M.B.A.
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Telephone | 404-496-8869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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