Provider Demographics
NPI:1275160897
Name:SEDULOUS, LLC
Entity Type:Organization
Organization Name:SEDULOUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-3105
Mailing Address - Street 1:4302 HOLLYWOOD BLVD STE 241
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6635
Mailing Address - Country:US
Mailing Address - Phone:305-300-3105
Mailing Address - Fax:
Practice Address - Street 1:4302 HOLLYWOOD BLVD STE 241
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6635
Practice Address - Country:US
Practice Address - Phone:305-300-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care