Provider Demographics
NPI: | 1669440608 |
---|---|
Name: | TAYLOR SUPPORT SERVICES, INC |
Entity type: | Organization |
Organization Name: | TAYLOR SUPPORT SERVICES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARIA |
Authorized Official - Middle Name: | ELANA |
Authorized Official - Last Name: | TAYLOR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | BA |
Authorized Official - Phone: | 727-430-8855 |
Mailing Address - Street 1: | PO BOX 21428 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT PETERSBURG |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33742-1428 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-430-8855 |
Mailing Address - Fax: | 727-866-8160 |
Practice Address - Street 1: | 2000 69TH AVE S |
Practice Address - Street 2: | |
Practice Address - City: | SAINT PETERSBURG |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33712-5822 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-430-8855 |
Practice Address - Fax: | 727-866-8160 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-03-08 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 251C00000X, 251C00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services |