Provider Demographics
NPI:1578192910
Name:LITTLE DEBBIE'S SECOND CHANCE HOMES FLORIDA
Entity Type:Organization
Organization Name:LITTLE DEBBIE'S SECOND CHANCE HOMES FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STIGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-509-9496
Mailing Address - Street 1:4280 MEMORIAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1216
Mailing Address - Country:US
Mailing Address - Phone:305-509-9496
Mailing Address - Fax:678-550-6491
Practice Address - Street 1:8379 GASPARILLA RD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-2819
Practice Address - Country:US
Practice Address - Phone:305-509-9496
Practice Address - Fax:678-550-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management