Provider Demographics
NPI:1861249732
Name:INFINITE DEVELOPMENTAL SERVICES LLC.
Entity type:Organization
Organization Name:INFINITE DEVELOPMENTAL SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZZARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-293-4911
Mailing Address - Street 1:5999 PURSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-1707
Mailing Address - Country:US
Mailing Address - Phone:850-607-3550
Mailing Address - Fax:
Practice Address - Street 1:5999 PURSLEY AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-1707
Practice Address - Country:US
Practice Address - Phone:850-607-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health