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General NPI Number Information
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NPI Number | 1609000827
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Entity Type | Organization
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Legal Business Name | PAULETTE'S ADULT FAMILY HOME
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10122 TIMMONS RD
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City | THONOTOSASSA
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State | FL
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Zip | 33592-3349
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Country | US
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Telephone | 813-986-1011
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Fax | 813-982-2039
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Provider Business Mailing Address
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Address Line | 10122 TIMMONS RD
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City | THONOTOSASSA
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State | FL
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Zip | 33592-3349
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Country | US
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Telephone | 813-986-1011
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Fax | 813-982-2039
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Authorized Official
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Title or Position | PROVIDER/CNA
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Name | MRS. PAULETTE C WALKER-SLATER
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Credential |
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Telephone | 813-986-1011
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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 | FL
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