# 01030712 LLC

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

## Provider details

- **NPI number:** 1184131435
- **Authorized official:** JOHN NEAL (OWNER)
- **Authorized official phone:** (561) 290-0980

## Contact information

- **Practice address:** 3801 PGA BLVD, SUITE 600 - OFFICE 651, PALM BEACH GARDENS, FL 33410
- **Practice address phone:** (561) 293-2522
- **Practice address fax:** (561) 284-8811
- **Mailing address:** 153 BENT TREE DR, PALM BEACH GARDENS, FL 33418-3599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2018
- **Last updated:** 01/09/2018