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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