Organization
PONKEYS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. POLLY NEDENE DUFFUS (PRESIDENT)
(754) 214-3169
Entity
Organization
Contact information
Practice address
4420 NW 23RD STREET, LAUDERHILL, FL 33313
(754) 214-3169
(954) 306-2314
Mailing address
4420 NW 23RD STREET, LAUDERHILL, FL 33313
(754) 214-3169
(954) 306-2314
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
—
691523096
—
FL
Enumeration date
11/22/2010
Last updated
11/22/2010
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