Organization
DELTONA HOME OF TLC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERI L. LONG (OWNER ADMINSTRATOR)
(352) 683-5255
Entity
Organization
Contact information
Practice address
1287 DELTONA BLVD, SPRING HILL, FL 34606
(352) 683-5255
(352) 683-2903
Mailing address
1287 DELTONA BLVD, SPRING HILL, FL 34606-4408
(352) 683-5255
(352) 683-2903
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6905138
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1414178
—
FL
05
—
691238996
—
FL
05
—
691238998
—
FL
Enumeration date
11/15/2013
Last updated
11/15/2013
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