Provider Demographics
NPI:1891385563
Name:SUPER FUN FRIENDSHIP GUILD INC.
Entity Type:Organization
Organization Name:SUPER FUN FRIENDSHIP GUILD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-226-3610
Mailing Address - Street 1:2811 SW ARCHER RD APT I70
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1859
Mailing Address - Country:US
Mailing Address - Phone:352-226-3610
Mailing Address - Fax:
Practice Address - Street 1:2811 SW ARCHER RD APT I70
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1859
Practice Address - Country:US
Practice Address - Phone:352-226-3610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services