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General NPI Number Information
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NPI Number | 1609409101
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Entity Type | Organization
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Legal Business Name | FLORIDA UNITED METHODIST CHILDRENS HOME, INC.
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 202 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-3200
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Country | US
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Telephone | 813-240-9980
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Fax |
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Provider Business Mailing Address
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Address Line | 51 CHILDRENS WAY
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City | ENTERPRISE
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State | FL
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Zip | 32725-8135
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Country | US
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Telephone | 386-668-4774
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF UTILIZATION MANAGEMENT
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Name | KAYLEE KATHRYN VANCE
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Credential |
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Telephone | 386-668-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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