Organization
CARE DELIVERY ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY CHILDRESS MHA, CMPE (ADMINISTRATIVE DIRECTOR)
(352) 323-5665
Entity
Organization
Contact information
Practice address
701 N PALMETTO ST, SUITE F, LEESBURG, FL 34748-4493
(352) 323-5665
(352) 323-1092
Mailing address
701 N PALMETTO ST, SUITE F, LEESBURG, FL 34748-4493
(352) 323-5665
(352) 323-1092
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
FL
Other
Enumeration date
09/03/2015
Last updated
09/08/2015
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