# ADULT FAMILY CARE HOME

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

## Provider details

- **NPI number:** 1669871083
- **Authorized official:** RHONDA RICHARDSON (OWNER/ADM)
- **Authorized official phone:** (863) 223-8104

## Contact information

- **Practice address:** 309 N WETMORE ST, LAKE WALES, FL 33853-4057
- **Practice address phone:** (863) 223-8104
- **Mailing address:** 309 N WETMORE ST, LAKE WALES, FL 33853-4057
- **Mailing address phone:** (863) 223-8104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 6906614 | FL | Yes |

## Other

- **Enumeration date:** 08/21/2014
- **Last updated:** 08/27/2014