Grand Rising Group Home LLC
NPI #1992495444 in Lehigh Acres, Florida
Provider Information
- NPI Number
- 1992495444
- Entity Type
- Organization
- Organization Name
- Grand Rising Group Home LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- May 9, 2023
- Last Updated
- May 9, 2023
Practice Location
- Address
- 3401 21ST ST SW
- City
- Lehigh Acres
- State
- Florida
- ZIP Code
- 33976-3513
- Phone
- (239) 634-6859
Authorized Official
- Name
- EMMANUEL JEAN, LPN
- Title
- OWNER
- Phone
- (239) 634-6859
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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