Organization
ICLIENT PERSONAL SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN K MILLER (CEO LLC)
(850) 902-9445
Entity
Organization
Contact information
Practice address
155 COUNTRY MANOR RD, DEFUNIAK SPRINGS, FL 32435
(850) 902-9445
Mailing address
155 COUNTRY MANOR RD, DEFUNIAK SPRINGS, FL 32435
(850) 902-9445
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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