Organization
TAKE WINGS AND SOAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH H. JACKSON (CFO/ADMINISTRATOR)
(941) 746-4240
Entity
Organization
Contact information
Practice address
2204 26TH AVE E, BRADENTON, FL 34208-7755
(941) 746-4240
(941) 746-1454
Mailing address
2204 26TH AVE E, BRADENTON, FL 34208-7755
(941) 746-4240
(941) 746-1454
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58662
TRADING PARTNER ID
FL
Enumeration date
02/01/2008
Last updated
04/20/2008
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