Provider Demographics
NPI:1588734511
Name:ANTONIA LANASA-ALGIE, INC.
Entity type:Organization
Organization Name:ANTONIA LANASA-ALGIE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANASA-ALGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-817-0170
Mailing Address - Street 1:6809 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-2535
Mailing Address - Country:US
Mailing Address - Phone:772-781-7017
Mailing Address - Fax:727-817-0170
Practice Address - Street 1:6809 OAK HILL DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2535
Practice Address - Country:US
Practice Address - Phone:727-817-0170
Practice Address - Fax:727-817-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL681069196251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL681069198Medicaid
FL681069196Medicaid