Organization
POPULUS PRIMUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISHA FOSTER (OWNER)
(727) 226-2196
Entity
Organization
Contact information
Practice address
14523 CALLEN GLEN WAY, WIMAUMA, FL 33598-6179
(727) 226-2196
Mailing address
14523 CALLEN GLEN WAY, WIMAUMA, FL 33598-6179
(727) 226-2196
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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