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Organization
SOVEREIGN DEVELOPMENTAL CENTER
Active
Organization
SOVEREIGN DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODY AUGUSTIN (AREA DIRECTOR)
(239) 271-4208
Entity
Organization
Contact information
Practice address
12553 NEW BRITTANY BLVD BLDG 32, FORT MYERS, FL 33907-3625
(239) 257-5300
Mailing address
12553 NEW BRITTANY BLVD BLDG 32, FORT MYERS, FL 33907-3625
(239) 257-5300
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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