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Organization
HOUSE OF BOSTICS LLC (THE)
Active
Organization
HOUSE OF BOSTICS LLC (THE)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALONDRIA N BOSTIC (ADMINISTRATOR)
(727) 550-7076
Entity
Organization
Contact information
Practice address
3586 53RD AVE N, SAINT PETERSBURG, FL 33714-2412
(727) 550-7076
(727) 329-9031
Mailing address
3586 53RD AVE N, SAINT PETERSBURG, FL 33714-2412
(727) 550-7076
(727) 329-9031
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
04/22/2020
Last updated
11/23/2022
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