BLACK CREEK SUPPORTS AND SERVICES, INC.
Agencies at Lismore Ct, Middleburg, FL

License number
Florida 232967
Category
Agencies
Type
In Home Supportive Care
Owner
Name: SHIELA BRYANT BUTLER
Title: PRESIDENT
Phone: (904) 449-2699
Address
Address
1700 Lismore Ct, Middleburg, FL 32068
National Provider ID: 1902214174
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BLACK CREEK SUPPORTS AND SERVICES INC

1700 Lismore Ct, Middleburg, FL 32068

Industry:
Business Services at Non-Commercial Site, Nonclassifiable Establishments
Doing business as:
Black Creek Supports and Services
Registration:
Oct 16, 2012
State ID:
P12000087201
Business type:
Florida Profit Corporation
Vice Presidents:
Shiela B Butler (President), 1700 Lismore Ct, Middleburg, FL 32068 (Physical),Frederick H Bryant, 2911 Circleridge Dr, Orange Park, FL 32065 (Physical),Austin R Bryant (Vice President), 1700 Lismore Ct, Middleburg, FL 32068 (Physical),...
Agent:
Shiela Butler,1700 Lismore Ct, Middleburg, FL 32068 (Physical)
EIN:
46-1200718

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