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Organization
CONTRACTORS GROUP
Active
Organization
CONTRACTORS GROUP
Active
Parent organization
G17000115761
Other names
Autism Home Healt hMoms
Organization subpart
Yes
Provider details
NPI number
Legal business name
G17000115761
Authorized official
MS. JILLIAN RICARD (OWNER)
(772) 924-5773
Entity
Organization
Contact information
Practice address
926 SE BELFAST AVE, PORT SAINT LUCIE, FL 34983-3914
(772) 924-5773
(772) 264-7865
Mailing address
926 SE BELFAST AVE, PORT SAINT LUCIE, FL 34983-3914
(772) 924-5773
(772) 264-7865
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688745
—
FL
Enumeration date
10/27/2017
Last updated
06/30/2022
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