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Organization
TANGERINE COVE PLC LLC
Active
Organization
TANGERINE COVE PLC LLC
Active
Other names
Tangerine Cove
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDWARD PETRAS JR. (CO-OWNER/COO)
(260) 797-9482
Entity
Organization
Contact information
Practice address
307 HOWELL AVE, BROOKSVILLE, FL 34601-2039
(260) 797-9482
Mailing address
3630 ILLINOIS RD, FORT WAYNE, IN 46804-2062
(260) 797-9482
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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