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Organization
FROM BOYS TO MEN GROUP HOME LLC
Active
Organization
FROM BOYS TO MEN GROUP HOME LLC
Active
Other names
JONATHAN BLANC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BLANC (OWNER)
(239) 357-0745
Entity
Organization
Contact information
Practice address
1403 SHADOW CREEK PL, BRANDON, FL 33510-2454
(239) 357-0745
Mailing address
1403 SHADOW CREEK PL, BRANDON, FL 33510-2454
(239) 357-0745
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/30/2025
Last updated
05/30/2025
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