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Organization
THE WILSON PLACE
Active
Organization
THE WILSON PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRAHAM DUNCAN LYLE II (ADMINISTATOR)
(321) 613-2867
Entity
Organization
Contact information
Practice address
117 WILSON AVE, COCOA BEACH, FL 32931-3981
(321) 613-2867
(321) 396-7855
Mailing address
117 WILSON AVE, COCOA BEACH, FL 32931-3981
(321) 613-2867
(321) 396-7855
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11786
FL
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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