Organization
NETTIE MAE BERRY FOUNDATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANDRA LAMIKIA SIMMONS (CEO)
(352) 258-3450
Entity
Organization
Contact information
Practice address
901 NW 8TH AVE STE A2, GAINESVILLE, FL 32601-5000
(352) 258-3450
(352) 379-5502
Mailing address
PO BOX 358774, GAINESVILLE, FL 32635-8774
(352) 258-3450
(352) 379-5502
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
10/24/2022
Last updated
09/03/2024
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