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Mrs. Tequela Yashan Donaldson
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Sanderson, Florida
NPI 1780154062

Tequela Yashan Donaldson is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Sanderson, FL. Tequela Yashan Donaldson practices in Sanderson, FL. The NPI Number for Tequela Yashan Donaldson is 1780154062 and holds a License No. (Florida).

The current practice location address for Tequela Yashan Donaldson is 14044 Friendship Pl, Sanderson, FL and can be reached out via phone at 904-408-6638 and via fax at 904-409-0012.

Location: 14044 Friendship Pl, Sanderson, FL, 32087-0163
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780154062
Provider Name
Tequela Yashan Donaldson
Credential
Provider Entity Type
Individual
Gender
Female
Address
14044 Friendship Pl, Sanderson, FL, 32087-0163
Phone Number
904-408-6638
Fax Number
904-409-0012
Provider Enumeration Date
11/29/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
735303 05 FL
institution
Provider Business Practice Location Address Details
Address
14044 Friendship Pl
City
Sanderson
State
Florida
Zip
32087-2489
Phone Number
904-408-6638
Fax Number
904-409-0012
person
Provider Business Mailing Address Details
Address
14044 Friendship Pl
City
Sanderson
State
Florida
Zip
32087-2489
Phone Number
904-408-6638
Fax Number
904-409-0012
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.
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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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