Provider Demographics
NPI:1609981539
Name:SUWANNEE VALLEY COMMUNITY COORDINATED CHILDCARE, INC
Entity Type:Organization
Organization Name:SUWANNEE VALLEY COMMUNITY COORDINATED CHILDCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:386-754-2222
Mailing Address - Street 1:236 SW COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-7036
Mailing Address - Country:US
Mailing Address - Phone:386-754-2222
Mailing Address - Fax:386-754-2220
Practice Address - Street 1:236 SW COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-7036
Practice Address - Country:US
Practice Address - Phone:386-754-2222
Practice Address - Fax:386-754-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)