Most Relevant Information
Provider Data
| NPI Number: | 1003352956 |
| Provider Name: | KIMBERKY STANFORD RN, BSBA, QMHP |
| Entity Type: | Individual |
| Taxonomy Code: | 310400000X |
| Specialty: | Assisted Living Facility |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/17/2017 |
| Last Updated: | 01/17/2017 |
Provider Practice Location
2512 CROTON AVE
SARASOTA
FL
342394907
Practice Location Phone/Fax
| Phone: | 9419603222 |
| Fax: |
Provider Mailing Location
2512 CROTON AVE
SARASOTA
FL
342394907
Provider Mailing Phone/Fax
| Phone: | 9419603222 |
| Fax: |