Organization
DPT GROUP SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINA WRIGHT (OWNER)
(352) 552-7971
Entity
Organization
Contact information
Practice address
2641 SHIRLEYS WAY APT 204, LEESBURG, FL 34748-3040
(352) 552-7971
Mailing address
2641 SHIRLEYS WAY APT 204, LEESBURG, FL 34748-3040
(352) 552-7971
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014968000
—
FL
Enumeration date
12/11/2015
Last updated
12/17/2015
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