Organization
SANDY LEMKE SUPPORTED LIVING SERVICES, INC.
Active
Organization
SANDY LEMKE SUPPORTED LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA ANN LEMKE (PRESIDENT)
(727) 823-9160
Entity
Organization
Contact information
Practice address
735 38TH AVE S, ST PETERSBURG, FL 33705-3837
(727) 823-9160
(727) 824-8841
Mailing address
PO BOX 16521, ST PETERSBURG, FL 33733-6521
(727) 823-9160
(727) 824-8841
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
672827801
MEDICAID DEVELOPMENTAL DISABILITIES FAMILY AND SUPPORTED LIVING WAIVER
FL
01
—
672827896
MEDICAID DEVELOPMENTAL DISABILITIES HOME AND COMMUNITY BASED WAIVER NUMBER
FL
Enumeration date
11/30/2010
Last updated
11/30/2010
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