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Peggy Mary Grogan
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Deland, Florida
NPI 1235883075

Peggy Mary Grogan is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Deland, FL. Peggy Mary Grogan practices in Deland, FL. The NPI Number for Peggy Mary Grogan is 1235883075 and holds a License No. 12-12-010 (Florida).

The current practice location address for Peggy Mary Grogan is 1721 Timber Edge Dr, Deland, FL and can be reached out via phone at 386-589-6313 and via fax at 386-626-2675.

Location: 1721 Timber Edge Dr, Deland, FL, 32724-7985
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235883075
Provider Name
Peggy Mary Grogan
Credential
Provider Entity Type
Individual
Gender
Female
Address
1721 Timber Edge Dr, Deland, FL, 32724-7985
Phone Number
386-589-6313
Fax Number
386-626-2675
Provider Enumeration Date
02/10/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1721 Timber Edge Dr
City
Deland
State
Florida
Zip
32724-7985
Phone Number
386-589-6313
Fax Number
386-626-2675
person
Provider Business Mailing Address Details
Address
1721 Timber Edge Dr
City
Deland
State
Florida
Zip
32724-7985
Phone Number
386-589-6313
Fax Number
386-626-2675
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
12-12-010 (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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