# LIFE LONG LEARNING CENTER 2

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

## Provider details

- **NPI number:** 1659630473
- **Authorized official:** MR. CHARLES HOWARD SWIHART (ADMINISTRATOR)
- **Authorized official phone:** (772) 237-2625

## Contact information

- **Practice address:** 406 SE FALLON DR, PORT SAINT LUCIE, FL 34983-2635
- **Practice address phone:** (772) 237-2625
- **Practice address fax:** (772) 237-2624
- **Mailing address:** 406 SE FALLON DR, PORT SAINT LUCIE, FL 34983-2635
- **Mailing address phone:** (772) 237-2625
- **Mailing address fax:** (772) 237-2624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | AL12123 | FL | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 05/14/2012