MEDICARE: DESIGNED FOR GREATNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1497565543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESIGNED FOR GREATNESS LLC

Provider Business Mailing Address
First Line	:	1211 NORMANDY HEIGHTS CIR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-5362
Country	:	US
Telephone Number	:	863-409-7332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 NORMANDY HEIGHTS CIR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-5362
Country	:	US
Telephone Number	:	863-409-7332
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHANTRALA NANTON
Credential	:
Telephone Number	:	863-409-7332

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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Directions to “DESIGNED FOR GREATNESS LLC ” Practice Location

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