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General NPI Number Information
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NPI Number | 1861281248
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Entity Type | Organization
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Legal Business Name | PEGGY JOYCE HARGROVE
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 3304 SAN MOISE PL
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City | PLANT CITY
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State | FL
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Zip | 33567-1719
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Country | US
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Telephone | 813-441-4231
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 VIA SIENA ST
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City | PLANT CITY
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State | FL
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Zip | 33566-1000
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Country | US
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Telephone | 813-965-4490
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PEGGY J HARGROVE
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Credential |
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Telephone | 813-965-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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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 | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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