Organization
FULTON HOME CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERTISHIA LASHANTI MOSLEY (CHIEF OF OPERATIONS)
(727) 565-9029
Entity
Organization
Contact information
Practice address
2308 FULTON WAY, LARGO, FL 33774-1517
(727) 565-9029
Mailing address
2308 FULTON WAY, LARGO, FL 33774-1517
(727) 565-9029
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022971400
—
FL
Enumeration date
05/10/2019
Last updated
05/10/2019
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