Organization
HARMONY FRUITION AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LATOYA JOHNSON LICENSED (OWNER)
(352) 234-5738
Entity
Organization
Contact information
Practice address
22513 SE 61ST AVE, HAWTHORNE, FL 32640-3640
(352) 234-5738
Mailing address
22513 SE 61ST AVE, HAWTHORNE, FL 32640-3640
(352) 234-5738
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/29/2020
Last updated
11/04/2020
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