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Organization
SEGULAH, INC.
Active
Organization
SEGULAH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTO MARIQUIT RPT (OWNER/PRESIDENT)
(321) 229-4168
Entity
Organization
Contact information
Practice address
2107 COUNTRY SIDE DR, APOPKA, FL 32712-2069
(321) 229-4168
(407) 814-3153
Mailing address
2107 COUNTRY SIDE DR, APOPKA, FL 32712-2069
(321) 229-4168
(407) 814-3153
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PT5636
FL
320700000X
Physical Disabilities Residential Treatment Facility
PT5636
FL
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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