Organization
THE CHILDREN'S HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDNES SMITH BOULANGER MSW (COUNSELING SERVICES MANAGER)
(813) 855-4435
Entity
Organization
Contact information
Practice address
10909 MEMORIAL HWY, TAMPA, FL 33615-2511
(813) 855-4435
Mailing address
522 39TH AVE NE, ST PETERSBURG, FL 33703-5918
(727) 822-6465
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
SW6638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767412100
—
FL
Enumeration date
02/02/2007
Last updated
07/11/2008
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