Provider Demographics
NPI:1689450470
Name:GENCARE KIDS PPEC PLUS LEARNING CENTER LAKELAND LLC
Entity Type:Organization
Organization Name:GENCARE KIDS PPEC PLUS LEARNING CENTER LAKELAND LLC
Other - Org Name:GENCARE KIDS PPEC PLUS LEARNING CENTER LAKELAND, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLIVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:888-425-7732
Mailing Address - Street 1:7405 US HIGHWAY 98 N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-2100
Mailing Address - Country:US
Mailing Address - Phone:888-425-7732
Mailing Address - Fax:407-440-2876
Practice Address - Street 1:7405 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-2100
Practice Address - Country:US
Practice Address - Phone:888-425-7732
Practice Address - Fax:407-440-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty