Organization
KELLY CARES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANICE KELLY (OWNER)
(386) 268-3318
Entity
Organization
Contact information
Practice address
1228 KENNEDY RD, DAYTONA BEACH, FL 32117-4120
(386) 268-3318
Mailing address
1228 KENNEDY RD, DAYTONA BEACH, FL 32117-4120
(386) 268-3318
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107308600
—
FL
Enumeration date
07/08/2020
Last updated
05/17/2021
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