Organization
GOOD SAMARITAN VILLAGE LLLP
Active
Organization
GOOD SAMARITAN VILLAGE LLLP
Active
Other names
Good Samaritan Village LLLP
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK APPIAH (MEMBER)
(203) 558-4189
Entity
Organization
Contact information
Practice address
26442 WHIRLAWAY TER, WESLEY CHAPEL, FL 33544-1552
(860) 794-6457
Mailing address
26442 WHIRLAWAY TER, WESLEY CHAPEL, FL 33544-1552
(203) 558-4189
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
714547
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714547
—
FL
Enumeration date
08/15/2018
Last updated
08/15/2018
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