Organization
A .L. PANTAGES INC.
Active
Other names
SR'S ARE US ADULT DAY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY LOU PANTAGES (CEO)
(386) 673-3255
Entity
Organization
Contact information
Practice address
1321 RIDGEWOOD AVE, HOLLY HILL, FL 32117-2319
(386) 673-3255
Mailing address
1321 RIDGEWOOD AVE, HOLLY HILL, FL 32117-2319
(386) 673-3255
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
AD8854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675582800
—
FL
05
—
675582896
—
FL
05
—
675582898
—
FL
Enumeration date
02/05/2009
Last updated
02/05/2009
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