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Organization
SUNCOAST NEW OPTIONS WALNUT STREET, LLC
Active
Organization
SUNCOAST NEW OPTIONS WALNUT STREET, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JOHNS BENSON (DIRECTOR OF BILLING)
(336) 553-5946
Entity
Organization
Contact information
Practice address
1370 S. WALNUT STREET, STARKE, FL 32091
(919) 390-2980
Mailing address
6531 MERIDIEN DR STE 103, RALEIGH, NC 27616-3213
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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