Organization
HODGE'S GROUP HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HODGE (PRESIDENT)
(407) 496-7356
Entity
Organization
Contact information
Practice address
4001 KALUGA PARK ST, ORLANDO, FL 32808-7473
(407) 496-7356
Mailing address
4001 KALUGA PARK ST, ORLANDO, FL 32808-7473
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
684197001
—
FL
Enumeration date
09/21/2015
Last updated
09/21/2015
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