Organization
TERESA MCFETRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MCFETRIDGE (OWNER)
(727) 255-3746
Entity
Organization
Contact information
Practice address
5714 MONROE ST, NEW PORT RICHEY, FL 34653-4260
(727) 255-3746
Mailing address
5714 MONROE ST, NEW PORT RICHEY, FL 34653-4260
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906035
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691014996
—
FL
Enumeration date
07/19/2013
Last updated
07/19/2013
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