Organization
PEDIATRIC ALTERNATIVE TREATMENT CARE, HOUSING & EVALUATION SERVICES
Active
Other names
PATCHES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AZONA KYLE SMITH (CEO)
(305) 242-8122
Entity
Organization
Contact information
Practice address
4300 OKEECHOBEE RD, FORT PIERCE, FL 34947-5407
(772) 462-6601
(772) 462-6632
Mailing address
335 S KROME AVE, SUITE 104, FLORIDA CITY, FL 33034-4906
(305) 242-8122
(305) 242-8837
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
60080987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240023501
—
FL
Enumeration date
06/10/2008
Last updated
09/11/2019
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