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Organization

LOGISTIQUE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY A HOUSTON (OWNER/CHIEF EXECUTIVE OFFICER)
(941) 224-2258
Entity
Organization

Contact information

Practice address
10300 49TH ST N, CLEARWATER, FL 33762-5000
(941) 224-2258
(813) 315-9376
Mailing address
10300 49TH ST N, CLEARWATER, FL 33762-5000
(941) 224-2258
(813) 315-9376

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other

Enumeration date
09/13/2023
Last updated
09/13/2023
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