Organization
COMMUNITY EXPERIENCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L CARREOLA (DIRECTOR/OWNER)
(850) 261-8403
Entity
Organization
Contact information
Practice address
321 N DEVILLERS ST SUITE 221, PENSACOLA, FL 32502
(850) 261-8403
(850) 458-8177
Mailing address
11107 LITTLE CREEK LN, PENSACOLA, FL 32506-8262
(850) 261-8403
(850) 458-8177
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002217700
—
FL
05
—
686104196
—
FL
Enumeration date
08/28/2014
Last updated
08/28/2014
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