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General NPI Number Information
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NPI Number | 1922176056
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Entity Type | Organization
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Legal Business Name | SUNSET SUPPORT SERVICES,INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 18101 BURRELL RD
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City | ODESSA
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State | FL
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Zip | 33556-5130
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Country | US
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Telephone | 813-679-3109
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Fax | 813-926-9527
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Provider Business Mailing Address
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Address Line | 18101 BURRELL RD
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City | ODESSA
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State | FL
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Zip | 33556-5130
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Country | US
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Telephone | 813-679-3109
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Fax | 813-926-9527
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BETSY D ISAAC
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Credential |
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Telephone | 813-679-3109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | VF001
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License Number State | FL
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