Provider Demographics
NPI:1265844013
Name:PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Entity Type:Organization
Organization Name:PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Other - Org Name:PEDIATRIC HEALTH CHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOSTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-769-5358
Mailing Address - Street 1:8509 BENJAMIN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5505 JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2324
Practice Address - Country:US
Practice Address - Phone:318-625-0410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care