None at This Time
NPI #1730621590 in Winter Haven, Florida
Provider Information
- NPI Number
- 1730621590
- Entity Type
- Organization
- Organization Name
- None at This Time
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Nov 10, 2016
- Last Updated
- Nov 10, 2016
Practice Location
- Address
- 725 CRESTWOOD DR
- City
- Winter Haven
- State
- Florida
- ZIP Code
- 33881-2919
- Phone
- (863) 618-9182
Authorized Official
- Name
- MISS WILENE CHARLEMONT PIERRE, R.N.
- Title
- ASSITANT DIRECTOR OF NURSING
- Phone
- (863) 618-9182
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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