Organization
GOODWILL INDUSTRIES-SUNCOAST, INC.
Active
Organization
GOODWILL INDUSTRIES-SUNCOAST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH ANN PASSERINI (CEO DESIGNATE/EXEC VP/COO)
(727) 523-1512
Entity
Organization
Contact information
Practice address
10596 GANDY BLVD N, ST PETERSBURG, FL 33702-1422
(727) 523-1512
(727) 450-5214
Mailing address
10596 GANDY BLVD N, ST PETERSBURG, FL 33702-1422
(727) 523-1512
(727) 450-5214
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
024013396
FL
251C00000X
Developmentally Disabled Services Day Training Agency
024013398
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024013396
—
FL
05
—
024013398
—
FL
Enumeration date
11/02/2012
Last updated
11/02/2012
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