# GMW I CARE SUPPORT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205291911
- **Authorized official:** MRS. GENORA MICHELLE WALKER (OWNER)
- **Authorized official phone:** (813) 389-0628

## Contact information

- **Practice address:** 10209 N 22ND ST, TAMPA, FL 33612-7021
- **Practice address phone:** (813) 422-7293
- **Practice address fax:** (813) 423-6680
- **Mailing address:** 10209 N 22ND ST, TAMPA, FL 33612-7021
- **Mailing address phone:** (813) 389-0628
- **Mailing address fax:** (813) 631-1429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | 692384496 | FL | — |
| 253Z00000X | In Home Supportive Care Agency | 692384496 | FL | Yes |
| 385HR2065X | Child Physical Disabilities Respite Care | 692384496 | FL | — |

## Other

- **Enumeration date:** 12/22/2015
- **Last updated:** 12/22/2015