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Organization
LIVING SOUTHERN STYLE OF BREVARD
Active
Organization
LIVING SOUTHERN STYLE OF BREVARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELIA A WALKER (ADMINISTRATOR)
(321) 208-7681
Entity
Organization
Contact information
Practice address
821 GEORGIA AVE, ROCKLEDGE, FL 32955-2022
(321) 208-7681
(321) 208-7681
Mailing address
821 GEORGIA AVE, ROCKLEDGE, FL 32955-2022
(321) 208-7681
(321) 208-7681
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
12363
FL
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
12363
FL
Other
Enumeration date
05/27/2013
Last updated
05/27/2013
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