Provider Demographics
NPI:1740173863
Name:MS TUTU'S @ PATRECE PLACE INC
Entity type:Organization
Organization Name:MS TUTU'S @ PATRECE PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VENICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-251-9942
Mailing Address - Street 1:144 STEVENS DR
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:FL
Mailing Address - Zip Code:32343-2686
Mailing Address - Country:US
Mailing Address - Phone:850-251-9942
Mailing Address - Fax:
Practice Address - Street 1:144 STEVENS DR
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:FL
Practice Address - Zip Code:32343-2686
Practice Address - Country:US
Practice Address - Phone:850-251-9942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services