# PRIVATE LIFE RETIREMENT PLACE, INC

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

## Provider details

- **NPI number:** 1326478488
- **Authorized official:** VIVIANE DERONVIL (OWNER)
- **Authorized official phone:** (954) 588-1941

## Contact information

- **Practice address:** 1451 NE 30TH ST, POMPANO BEACH, FL 33064-6834
- **Practice address phone:** (954) 588-1941
- **Mailing address:** 1451 NE 30TH ST, POMPANO BEACH, FL 33064-6834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/26/2013
- **Last updated:** 11/26/2013