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General NPI Number Information
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NPI Number | 1689181208
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Entity Type | Organization
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Legal Business Name | FAMILY SOARING
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 10800 BRIGHTON BAY BLVD NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33716-3478
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Country | US
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Telephone | 727-564-7769
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Fax | 727-800-5144
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Provider Business Mailing Address
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Address Line | 10800 BRIGHTON BAY BLVD NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33716-3478
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Country | US
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Telephone | 727-564-7769
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Fax | 727-800-5144
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Authorized Official
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Title or Position | CEO
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Name | EVANGELA DILLARD
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Credential |
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Telephone | 727-564-7769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 7304
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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