Organization
GWENANDREWS HOME OF SUCCESS AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EREKA ANDREWS REDDICK (EXECUTIVE DIRECTOR)
(850) 875-0075
Entity
Organization
Contact information
Practice address
116 N MADISON ST, QUINCY, FL 32351-2411
(850) 875-0075
(850) 627-2614
Mailing address
116 N MADISON ST, QUINCY, FL 32351-2411
(850) 875-0075
(850) 627-2614
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
691333496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002214300
—
FL
05
—
691333496
—
FL
Enumeration date
09/17/2013
Last updated
09/17/2013
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