Provider Demographics
NPI:1598447005
Name:PPEC OF FL SUPPORT, LLC
Entity Type:Organization
Organization Name:PPEC OF FL SUPPORT, LLC
Other - Org Name:THE KIDZ CLUB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-724-9831
Mailing Address - Street 1:1101 HERR LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4301
Mailing Address - Country:US
Mailing Address - Phone:502-210-5538
Mailing Address - Fax:502-327-5098
Practice Address - Street 1:850 3RD AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4010
Practice Address - Country:US
Practice Address - Phone:502-724-9831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KYPPEC,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care