Organization
SUNCOAST COMMUNITY CONNECTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG CLARK M.ED. (MANAGING MEMBER)
(941) 587-5921
Entity
Organization
Contact information
Practice address
2033 SANDRALA DR, SARASOTA, FL 34231-3425
(941) 587-5921
Mailing address
PO BOX 18022, SARASOTA, FL 34276-1022
(941) 587-5921
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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