Organization
KENDUCK IZQUIERDO SUPPORT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA M KENDUCK (CO OWNER/PRESIDENT)
(352) 362-8074
Entity
Organization
Contact information
Practice address
7860 SW 204TH AVE, DUNNELLON, FL 34431-5169
(352) 362-8074
(352) 465-3243
Mailing address
7860 SW 204TH AVE, DUNNELLON, FL 34431-5169
(352) 362-8074
(352) 465-3243
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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