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Organization

RNG AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROGERICK GREEN SR. (OWNER/ CARE COORDINATION)
(813) 297-8112
Entity
Organization

Contact information

Practice address
7853 GUNN HWY # 133, TAMPA, FL 33626-1611
(813) 297-8112
(877) 799-6786
Mailing address
7853 GUNN HWY # 133, TAMPA, FL 33626-1611
(813) 297-8112
(877) 799-6786

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
03/06/2018
Last updated
03/06/2018
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