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Organization
SHALIMARE INC.
Active
Organization
SHALIMARE INC.
Active
Other names
Shalimare Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ELLEN PROVENCHER (PRESIDENT OF SHALIMARE INC.)
(239) 839-4997
Entity
Organization
Contact information
Practice address
613 CAROLINA AVE, FORT MYERS, FL 33905-4015
(239) 839-4997
(239) 693-1121
Mailing address
613 CAROLINA AVE, FORT MYERS, FL 33905-4015
(239) 839-4997
(239) 693-1121
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
NULL
Other
Enumeration date
06/27/2007
Last updated
08/22/2020
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