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1669731808
CHARITY PROVANCAL-BLACK
GAINESVILLE, FL
NPI
1669731808
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2012-05-09
Last Update Date
2012-05-09
Business Address
-- CHARITY PROVANCAL-BLACK
4300 SW 13TH ST
GAINESVILLE, FL 32608-4006
Phone number: 352-374-5600
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Mailing Address
-- CHARITY PROVANCAL-BLACK
4300 SW 13TH ST
GAINESVILLE, FL 32608-4006
Phone number:
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