Provider Demographics
NPI: | 1295897866 |
---|---|
Name: | CHALLENGING IDEAS INC |
Entity type: | Organization |
Organization Name: | CHALLENGING IDEAS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | VIRGINIA |
Authorized Official - Middle Name: | JESSICA |
Authorized Official - Last Name: | RIGGS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 813-312-1921 |
Mailing Address - Street 1: | 33433 PLEASANT LN |
Mailing Address - Street 2: | |
Mailing Address - City: | DADE CITY |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33523-9066 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-312-1921 |
Mailing Address - Fax: | 352-583-4568 |
Practice Address - Street 1: | 33433 PLEASANT LN |
Practice Address - Street 2: | |
Practice Address - City: | DADE CITY |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33523-9066 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-312-1921 |
Practice Address - Fax: | 352-583-4568 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-13 |
Last Update Date: | 2013-01-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 675992196 | Medicaid |