Organization
HIDDEN POTENTIALS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY CLINTON (EXECUTIVE DIRECTOR)
(321) 267-6318
Entity
Organization
Contact information
Practice address
5650 S WASHINGTON AVE, TITUSVILLE, FL 32780-7312
(321) 267-6318
(321) 267-1194
Mailing address
5650 S WASHINGTON AVE, TITUSVILLE, FL 32780-7312
(321) 267-6318
(321) 267-1194
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
960146896
—
FL
Enumeration date
05/06/2009
Last updated
05/06/2009
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