Organization
SUGARS SUPPORTIVE SERVICES, LLC
Active
Organization
SUGARS SUPPORTIVE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORRAINE ADELE CALDWELL (OWNER)
(352) 617-0400
Entity
Organization
Contact information
Practice address
2204 CITRUS BLVD, SUITE 10B, LEESBURG, FL 34748-3019
(352) 435-4600
(352) 435-4605
Mailing address
2204 CITRUS BLVD, SUITE 10B, LEESBURG, FL 34748-3019
(352) 435-4600
(352) 435-4605
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
001917900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001917900
—
FL
05
—
690259696
—
FL
Enumeration date
08/04/2015
Last updated
08/04/2015
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