person
Zandra Wynette Wallace
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tampa, Florida
NPI 1053063412

Zandra Wynette Wallace is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Tampa, FL. Zandra Wynette Wallace practices in Tampa, FL. The NPI Number for Zandra Wynette Wallace is 1053063412 and holds a License No. (Florida).

The current practice location address for Zandra Wynette Wallace is 20316 Natures Corner Dr, Tampa, FL and can be reached out via phone at 813-575-8108.

Location: 20316 Natures Corner Dr, Tampa, FL, 33647-3580
person
Provider Profile Details
NPI Number
1053063412
Provider Name
Zandra Wynette Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
20316 Natures Corner Dr, Tampa, FL, 33647-3580
Phone Number
813-575-8108
Fax Number
Provider Enumeration Date
01/26/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
20316 Natures Corner Dr
City
State
Zip
33647-3580
Phone Number
813-575-8108
Fax Number
person
Provider Business Mailing Address Details
Address
20316 Natures Corner Dr
City
State
Zip
33647-3580
Phone Number
813-575-8108
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
(Florida)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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