GLADYS B HOUSE LLC NPI 1891221065

NPI Information

NPI: 1891221065
Provider Name: GLADYS B HOUSE, LLC

Doing Business As: GLADYS B HOUSE, LLC

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
12875 SW 280TH ST
HOMESTEAD, FL
ZIP 33032
Phone: (813) 528-6979
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GLADYS B HOUSE, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Homestead, FL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. GLADYS B HOUSE, LLC NPI is 1891221065. The provider is registered as an organization entity type.
The provider Is Doing Business As Gladys B House, Llc.

The provider's business location address is:

12875 SW 280TH ST
HOMESTEAD, FL
ZIP 33032
Phone: (813) 528-6979

The provider's authorized official is Susan Mclean .
The authorized official title is Executive Director and has the following contact phone number (813) 528-6979.

The enumeration date for this NPI number is 5/10/2017 and was last updated on 5/11/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251E00000X	Home Health		No
2	253Z00000X	In Home Supportive Care		No
3	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness	No
4	347C00000X	Private Vehicle		No
5	385HR2065X	Respite Care	Respite Care, Physical Disabilities, Child	No
6	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1891221065	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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