Organization
LIVING THERAPEUTICALLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TJUANA Y MCNEILLY REGISTERED NURSE (CEO/OWNER)
(850) 450-6074
Entity
Organization
Contact information
Practice address
301 E MORENO ST, PENSACOLA, FL 32503-5257
(850) 450-6074
Mailing address
301 E MORENO ST, PENSACOLA, FL 32503-5257
(850) 450-6074
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
RN9420644
FL
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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