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General NPI Number Information
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NPI Number | 1609981539
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Entity Type | Organization
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Legal Business Name | SUWANNEE VALLEY COMMUNITY COORDINATED CHILDCARE, INC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 236 SW COLUMBIA AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-7036
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Country | US
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Telephone | 386-754-2222
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Fax | 386-754-2220
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Provider Business Mailing Address
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Address Line | 236 SW COLUMBIA AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-7036
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Country | US
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Telephone | 386-754-2222
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Fax | 386-754-2220
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MICHELE ANNE WARD
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Credential | C.E.O.
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Telephone | 386-754-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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