Provider Demographics
NPI:1699806190
Name:DAKOTA SHEBA LLC
Entity Type:Organization
Organization Name:DAKOTA SHEBA LLC
Other - Org Name:APLUS HOMEAID
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-644-7396
Mailing Address - Street 1:140 N ORLANDO AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3606
Mailing Address - Country:US
Mailing Address - Phone:407-644-7396
Mailing Address - Fax:
Practice Address - Street 1:140 N ORLANDO AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3606
Practice Address - Country:US
Practice Address - Phone:407-644-7396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229143251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685502400Medicaid
FL684088496Medicaid
FL684088498Medicaid