Provider Demographics
NPI:1578676383
Name:DARLA WILSON INC
Entity Type:Organization
Organization Name:DARLA WILSON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-212-1701
Mailing Address - Street 1:3970 N BLUEWATER DR
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-3150
Mailing Address - Country:US
Mailing Address - Phone:352-212-1701
Mailing Address - Fax:352-637-6654
Practice Address - Street 1:3970 N BLUEWATER DR
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-3150
Practice Address - Country:US
Practice Address - Phone:352-212-1701
Practice Address - Fax:352-637-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services