Provider Demographics
NPI:1336959477
Name:DESIGNED FOR GREATNESS LLC
Entity type:Organization
Organization Name:DESIGNED FOR GREATNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANTRALA
Authorized Official - Middle Name:EUTICA
Authorized Official - Last Name:NANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-409-7332
Mailing Address - Street 1:1211 NORMANDY HEIGHTS CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5362
Mailing Address - Country:US
Mailing Address - Phone:863-409-7332
Mailing Address - Fax:
Practice Address - Street 1:1211 NORMANDY HEIGHTS CIR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-5362
Practice Address - Country:US
Practice Address - Phone:863-409-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No342000000XTransportation ServicesTransportation Network Company
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care