Organization
DARLEEN UNIQUE PROVIDER SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE DESSOURCES (PROVIDER)
(954) 655-9682
Entity
Organization
Contact information
Practice address
681 SW FREDRICA ST, PORT SAINT LUCIE, FL 34983-1875
(954) 655-9682
Mailing address
681 SW FREDRICA ST, PORT SAINT LUCIE, FL 34983-1875
(954) 655-9682
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
07/17/2016
Last updated
08/04/2021
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