Provider Demographics
NPI:1679765317
Name:SHOWERS TO SUNFLOWERS, INC
Entity Type:Organization
Organization Name:SHOWERS TO SUNFLOWERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMMISENIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOLLOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-856-5795
Mailing Address - Street 1:PO BOX 1461
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32353-1461
Mailing Address - Country:US
Mailing Address - Phone:850-856-5798
Mailing Address - Fax:850-856-5062
Practice Address - Street 1:3407 GLORY RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32352-8040
Practice Address - Country:US
Practice Address - Phone:850-856-5798
Practice Address - Fax:850-856-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25100000X251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services