Organization
PETERSON FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHEVONE L. PETERSON (DIRECTOR)
(239) 770-4235
Entity
Organization
Contact information
Practice address
3507 LEE BLVD STE 273, LEHIGH ACRES, FL 33971-1323
(239) 770-4235
(888) 203-0442
Mailing address
3507 LEE BLVD STE 273, LEHIGH ACRES, FL 33971-1323
(239) 770-4235
(888) 203-0442
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
342000000X
Transportation Network Company
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009279700
—
FL
Enumeration date
10/24/2018
Last updated
01/28/2022
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