# KATIE HAYNES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Katie Haynes
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649745399
- **Authorized official:** KATIE HAYNES (OWNER CAREGIVER)
- **Authorized official phone:** (727) 276-2515

## Contact information

- **Practice address:** 4123 WHITING DR SE, ST PETERSBURG, FL 33705-4061
- **Practice address phone:** (727) 276-2515
- **Mailing address:** 4123 WHITING DR SE, ST PETERSBURG, FL 33705-4061
- **Mailing address phone:** (727) 276-2515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/09/2018
- **Last updated:** 01/15/2020