Evening Tide of Brevard, LLC
NPI #1184087694 in Cocoa Beach, Florida
Provider Information
- NPI Number
- 1184087694
- Entity Type
- Organization
- Organization Name
- Evening Tide of Brevard, LLC
- Primary Specialty
- Home Health
- Enumeration Date
- Apr 1, 2016
- Last Updated
- Apr 1, 2016
Practice Location
- Address
- 100 N ORLANDO AVE
- City
- Cocoa Beach
- State
- Florida
- ZIP Code
- 32931-2915
- Phone
- (321) 613-4569
Authorized Official
- Name
- MR. STEVEN DOUGLAS TRACY, NA
- Title
- EXECUTIVE DIRECTOR
- Phone
- (435) 760-4091
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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