Provider Demographics
NPI:1215401187
Name:ST ANNES CARE AGENCY INC
Entity Type:Organization
Organization Name:ST ANNES CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIMOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-701-0718
Mailing Address - Street 1:1119 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-4741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1119 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-4741
Practice Address - Country:US
Practice Address - Phone:954-701-0718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities