Individual
ERLINE EXUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10835 HOFFNER EDGE DR, RIVERVIEW, FL 33579-4058
(305) 923-8996
Mailing address
10835 HOFFNER EDGE DR, RIVERVIEW, FL 33579-4058
(305) 923-8996
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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