Specialneeds4Special PPL

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

License

691661996 Issued in FL

Legal business name

SPECIALNEEDS4SPECIAL PPL

Practice address

12040 Pitcairn St
Brooksville, FL 34613-4724

Phone

(352) 442-4149

Fax

(352) 556-2350

NPI assigned

Jan 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth June Duncan

Title

Owner

Phone

(352) 442-4149

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1992242812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 PITCAIRN ST",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346134724",
            "telephone_number": "352-442-4149",
            "fax_number": "352-556-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 PITCAIRN ST",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346134724",
            "telephone_number": "352-442-4149",
            "fax_number": "352-556-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALNEEDS4SPECIAL PPL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-442-4149"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "691661996",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "FL",
            "license": "691661996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.