# GENA OBRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023410545
- **Authorized official:** GENA OBRY (OWNER)
- **Authorized official phone:** (863) 229-5419

## Contact information

- **Practice address:** 439 AVENUE D SE, WINTER HAVEN, FL 33880-3531
- **Practice address phone:** (863) 229-5419
- **Mailing address:** 439 AVENUE D SE, WINTER HAVEN, FL 33880-3531
- **Mailing address phone:** (863) 229-5419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 6906588 | FL | Yes |

## Other

- **Enumeration date:** 09/17/2014
- **Last updated:** 09/17/2014