Organization
EM2 AFFILIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLA MAYO (CEO/PRESIDENT)
(305) 972-1026
Entity
Organization
Contact information
Practice address
244 NW 22ND ST, HOMESTEAD, FL 33030-3130
(305) 972-1026
(407) 593-1771
Mailing address
PO BOX 700538, SAINT CLOUD, FL 34770-0538
(305) 972-1026
(407) 593-1771
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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