| Great Expectations Kid's Home | |
|
11216 108th Way Largo FL 33778-3320 | |
| (727) 488-1493 | |
| Not Available |
| Full Name | Great Expectations Kid's Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11216 108th Way, Largo, Florida |
| Authorized Official Name and Position | George F Ensor (ADMINITRATOR) |
| Authorized Official Contact | 7277351317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Expectations Kid's Home 13494 Walsingham Rd Largo FL 33774-3527 Ph: (727) 735-1317 | Great Expectations Kid's Home 11216 108th Way Largo FL 33778-3320 Ph: (727) 488-1493 |
| NPI Number | 1992309660 |
|---|---|
| Provider Enumeration Date | 11/24/2020 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992309660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
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