Organization
THERESA WILLIAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA L WILLIAMS (LPN)
(352) 748-7032
Entity
Organization
Contact information
Practice address
301 STONE ST, WILDWOOD, FL 34785-3344
(352) 748-7032
(352) 748-7032
Mailing address
301 STONE ST, WILDWOOD, FL 34785-3344
(352) 748-7032
(352) 748-7032
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
FL
347C00000X
Private Vehicle
WER1234
FL
385H00000X
Respite Care
—
FL
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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