Organization
CAREOLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA TYRONE PETERKIN SR. (MANAGING DIRECTOR)
(352) 250-2237
Entity
Organization
Contact information
Practice address
3248 LANDING VW, TAVARES, FL 32778-2035
(352) 250-2237
(352) 327-7030
Mailing address
3248 LANDING VW, TAVARES, FL 32778-2035
(352) 250-2237
(352) 327-7030
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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