Blake Homes LLC

Organization Active NPI Developmental Disabilities Clinic/Center · Summerfield, FL

NPI 1467960385 · NPPES record last updated Jan 12, 2018

Key facts

NPI
1467960385
Entity type
Organization (NPI type 2)
Primary specialty
Developmental Disabilities Clinic/Center 261QD1600X
Legal business name
BLAKE HOMES LLC
Practice address
15085 SE 73Rd Ave
Summerfield, FL 34491-4226
Phone
(352) 504-6979
NPI assigned
Jan 12, 2018
Organization subpart
No

Authorized official

Name
Kyle Blake
Title
Owner
Phone
(352) 504-6979

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X FL Yes

Addresses

Primary practice location

15085 SE 73Rd Ave
Summerfield, FL 34491-4226

Mailing address

15085 SE 73Rd Ave
Summerfield, FL 34491-4226

Other identifiers

IdentifierTypeStateIssuer
691440OtherFLATN

Other providers in Summerfield, FL

All providers in Summerfield, FL · Developmental Disabilities Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.