Provider Demographics
NPI:1437888450
Name:PS PROVIDING SUPPORTS
Entity Type:Organization
Organization Name:PS PROVIDING SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-689-3695
Mailing Address - Street 1:381 MELODY CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-1055
Mailing Address - Country:US
Mailing Address - Phone:239-689-3695
Mailing Address - Fax:
Practice Address - Street 1:381 MELODY CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-1055
Practice Address - Country:US
Practice Address - Phone:239-689-3695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care