Provider Demographics
NPI:1104401363
Name:REACTION RESOURCES INC
Entity Type:Organization
Organization Name:REACTION RESOURCES INC
Other - Org Name:PARADISE OF ADORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SKANNAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-504-6072
Mailing Address - Street 1:5110 PEACHGREEN CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4877
Mailing Address - Country:US
Mailing Address - Phone:813-504-6072
Mailing Address - Fax:
Practice Address - Street 1:5110 PEACHGREEN CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-4877
Practice Address - Country:US
Practice Address - Phone:813-504-6072
Practice Address - Fax:813-504-6072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REACTION RESOURCES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-09
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031077062680Medicaid