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Erica Denise Irvin
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tavares, Florida
NPI 1487173753

Erica Denise Irvin is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Tavares, FL. Erica Denise Irvin practices in Tavares, FL. The NPI Number for Erica Denise Irvin is 1487173753 and holds a License No. (Florida).

The current practice location address for Erica Denise Irvin is 4681 Marsh Harbor Dr, Tavares, FL and can be reached out via phone at 352-602-1308.

Location: 4681 Marsh Harbor Dr, Tavares, FL, 32778-4764
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487173753
Provider Name
Erica Denise Irvin
Credential
Provider Entity Type
Individual
Gender
Female
Address
4681 Marsh Harbor Dr, Tavares, FL, 32778-4764
Phone Number
352-602-1308
Fax Number
Provider Enumeration Date
09/18/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
684300 05 FL
institution
Provider Business Practice Location Address Details
Address
4681 Marsh Harbor Dr
City
Tavares
State
Florida
Zip
32778
Phone Number
352-602-1308
Fax Number
person
Provider Business Mailing Address Details
Address
4681 Marsh Harbor Dr
City
Tavares
State
Florida
Zip
32778
Phone Number
352-602-1308
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
320900000X
License No.
()
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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