Individual provider · Type 1 NPI
Peggy Mary Grogan
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Deland, FL
Practice location
1721 Timber Edge Dr
Deland, FL 32724-7985
Fax (386) 626-2675
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 12-12-010 (FL) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1235883075
Peggy Mary Grogan's National Provider Identifier is 1235883075, issued on Feb 10, 2022. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Deland, FL. The record was last updated on Feb 10, 2022.