Organization
DEANNA ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA CELES JOHNSON (OWNER)
(813) 251-8506
Entity
Organization
Contact information
Practice address
2325 W PINE ST, TAMPA, FL 33607-3456
(813) 251-8506
Mailing address
2325 W PINE ST, TAMPA, FL 33607-3456
(813) 251-8506
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013103000
—
FL
Enumeration date
03/07/2016
Last updated
03/07/2016
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