Organization
THE KIDZ CLUB- ST PETE,LLC
Active
Other names
The Kidz Club
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE A HUNT (VP OF OPERATIONS)
(502) 458-5433
Entity
Organization
Contact information
Practice address
1101 HERR LN, LOUISVILLE, KY 40222-4301
(502) 210-5538
(502) 327-5098
Mailing address
850 3RD AVE S, ST PETERSBURG, FL 33701-4033
(727) 821-5439
(727) 821-9459
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
2929960060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003967601
—
FL
Enumeration date
12/21/2012
Last updated
12/21/2012
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