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General NPI Number Information
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NPI Number | 1942990197
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Entity Type | Organization
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Legal Business Name | THRIVING OUTLOOK FOR PROSPERING SENIORS INC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 1101 LAKE HARRIS DR
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City | TAVARES
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State | FL
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Zip | 32778-4102
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Country | US
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Telephone | 352-554-9025
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Fax | 352-818-4476
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Provider Business Mailing Address
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Address Line | 2578 LIMERICK CIR
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City | GRAND ISLAND
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State | FL
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Zip | 32735-9006
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Country | US
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Telephone | 352-870-3439
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Fax |
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Authorized Official
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Title or Position | OPERATOR
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Name | MRS. NICHOLE BLAKE-LITTLE
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Credential | RN
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Telephone | 352-870-3439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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