Organization
SUPERHERO KIDS PPEC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELSEY ALLEN (OWNER ADMINISTRATOR)
(561) 877-2152
Entity
Organization
Contact information
Practice address
1700 W WOOLBRIGHT RD STE 3, BOYNTON BEACH, FL 33426-6346
(561) 877-2152
(561) 810-4197
Mailing address
1700 W WOOLBRIGHT RD STE 3, BOYNTON BEACH, FL 33426-6346
(561) 877-2152
(561) 810-4197
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60081108
AHCA PPEC LICENSE
FL
Enumeration date
01/27/2022
Last updated
01/27/2022
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