Active Care Group Home
NPI #1851626337 in St Petersburg, Florida
Provider Information
- NPI Number
- 1851626337
- Entity Type
- Organization
- Organization Name
- Active Care Group Home
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Oct 16, 2009
- Last Updated
- Oct 16, 2009
Practice Location
- Address
- 3935 43RD AVE N
- City
- St Petersburg
- State
- Florida
- ZIP Code
- 33714-3620
- Phone
- (727) 235-8753
Authorized Official
- Name
- ESMERALDA MANUKONDA
- Title
- PRESIDENT
- Phone
- (727) 452-0448
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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