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Organization
GMW I CARE SUPPORT SERVICES
Active
Organization
GMW I CARE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENORA MICHELLE WALKER (OWNER)
(813) 389-0628
Entity
Organization
Contact information
Practice address
10209 N 22ND ST, TAMPA, FL 33612-7021
(813) 422-7293
(813) 423-6680
Mailing address
10209 N 22ND ST, TAMPA, FL 33612-7021
(813) 389-0628
(813) 631-1429
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
692384496
FL
253Z00000X
In Home Supportive Care Agency
Primary
692384496
FL
385HR2065X
Child Physical Disabilities Respite Care
692384496
FL
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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