Organization
GLADY'S GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YAMARIS TATUM (CEO)
(772) 343-8472
Entity
Organization
Contact information
Practice address
213 SW LANGFIELD AVE, PORT SAINT LUCIE, FL 34984-4926
(772) 343-8472
(772) 879-6737
Mailing address
213 SW LANGFIELD AVE, PORT ST LUCIE, FL 34984-4926
(772) 343-8472
(772) 879-6737
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
689362796
FL
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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