Organization
WILSONS CARING PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY WILSON (EXECUTIVE DIRECTOR)
(727) 851-3949
Entity
Organization
Contact information
Practice address
5609 US HWY 19, STE G, NEW PORT RICHEY, FL 34652-3754
(727) 851-3949
(866) 675-0558
Mailing address
PO BOX 864, PORT RICHEY, FL 34673-0864
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022088500
—
FL
05
—
236478
—
FL
Enumeration date
05/05/2020
Last updated
09/24/2020
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