Individual provider · Type 1 NPI
Tice Ridley
Adult Care Home Facility · Dade City, FL
NPI number
1285258368
Active
Practice location
19717 Bower Rd
Dade City, FL 33523-6867
Fax (727) 499-7526
Mailing address
PO Box 406
Bay Pines, FL 33744-0406
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Another provider at this address
About NPI 1285258368
Tice Ridley's National Provider Identifier is 1285258368, issued on Jun 3, 2020. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Dade City, FL. The record was last updated on Jun 3, 2020.