Organization
KELLY, EMMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMMA LEE KELLY (OWNER)
(813) 571-2235
Entity
Organization
Contact information
Practice address
509 CALHOUN AVE, SEFFNER, FL 33584-3614
(813) 571-2235
(813) 571-2235
Mailing address
509 CALHOUN AVE, SEFFNER, FL 33584-3614
(813) 571-2235
(813) 571-2235
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905766
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142382700
—
FL
Enumeration date
08/22/2013
Last updated
08/22/2013
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