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Organization

SPECIALNEEDS4SPECIAL PPL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH JUNE DUNCAN (OWNER)
(352) 442-4149
Entity
Organization

Contact information

Practice address
12040 PITCAIRN ST, BROOKSVILLE, FL 34613-4724
(352) 442-4149
(352) 556-2350
Mailing address
12040 PITCAIRN ST, BROOKSVILLE, FL 34613-4724
(352) 442-4149
(352) 556-2350

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
691661996
FL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
691661996
FL

Other

Enumeration date
01/30/2017
Last updated
01/30/2017
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