Organization · NPI-2

41lifechangers LLC

Developmental Therapist · Ruskin, FL

NPI number1780088914
StatusActive
Last updated in NPPESOct 17, 2014

Details

NPI
1780088914
Entity type
Organization (NPI-2)
Legal business name
41lifechangers LLC
Organization subpart
No
Enumeration date
Oct 17, 2014
Last updated
Oct 17, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
222Q00000X Developmental Therapist––Yes

Practice location

1003 Windton Oak Dr
Ruskin, FL 33570-5330

Phone 941-807-6374

Mailing address

1003 Windton Oak Dr
Ruskin, FL 33570-5330

Phone 941-807-6374

Authorized official

Roderick Green
Owner
9418076374

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