Organization
TA FRIENDLY HELPERS
Active
Other names
TA Friendly helpers
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CLARENCE GREEN BSW (EXECUTIVE DIRECTOR)
(813) 863-5113
Entity
Organization
Contact information
Practice address
12316 BALLENTRAE FOREST DR, RIVERVIEW, FL 33579-9339
(813) 863-5113
Mailing address
12316 BALLENTRAE FOREST DR, RIVERVIEW, FL 33579-9339
(813) 863-5113
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015952700
—
FL
Enumeration date
12/10/2018
Last updated
06/24/2019
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