Organization
CHANTINA WILSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTINA WILSON WILSON (ADMINISTRATOR)
(813) 324-0180
Entity
Organization
Contact information
Practice address
5126 CLOVER MIST DR, APOLLO BEACH, FL 33572-3418
(813) 324-0180
Mailing address
3501 E FRIERSON AVE, TAMPA, FL 33610-5124
(813) 324-0180
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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