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Organization
VITALITY RESORT ALF LLC
Active
Organization
VITALITY RESORT ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTELLA DORVAL (ADMINISTRATOR)
(772) 207-7947
Entity
Organization
Contact information
Practice address
11380 SW HILLCREST CIR, PORT ST LUCIE, FL 34987-2704
(772) 207-7947
Mailing address
1258 SW ERMINE AVE, PORT ST LUCIE, FL 34953-5006
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012975500
—
FL
Enumeration date
02/07/2016
Last updated
02/07/2016
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