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Organization

KCVR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KARLISLE CALLAHAN (OWNER)
(727) 276-4853
Entity
Organization

Contact information

Practice address
3750 MCCLOUD ST, NEW PORT RICHEY, FL 34655-2606
(727) 276-4853
Mailing address
3750 MCCLOUD ST, NEW PORT RICHEY, FL 34655-2606
(727) 276-4853

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
04/22/2022
Last updated
04/22/2022
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