Provider Demographics
NPI:1316391022
Name:GLAM SQUAD
Entity Type:Organization
Organization Name:GLAM SQUAD
Other - Org Name:FLORIDAS HELPING HANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:727-226-7844
Mailing Address - Street 1:1763 MAIN ST
Mailing Address - Street 2:SUITE 241
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6436
Mailing Address - Country:US
Mailing Address - Phone:727-226-7844
Mailing Address - Fax:
Practice Address - Street 1:1763 MAIN ST
Practice Address - Street 2:SUITE 241
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6436
Practice Address - Country:US
Practice Address - Phone:727-226-7844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5224763251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care