Individual
MR. GARPHARD BEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3247 THORNY RIDGE DR, HOLIDAY, FL 34691-1554
(813) 406-3832
Mailing address
5314 LINDER PL, NEW PORT RICHEY, FL 34652-3734
(813) 406-3832
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
818144
—
FL
Enumeration date
11/25/2020
Last updated
11/25/2020
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