# COTIN-VALCIN, CHARITE ADULT FAMILY CARE HOME

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

## Provider details

- **NPI number:** 1730580648
- **Authorized official:** CHARITE VALCIN-COTIN (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (772) 985-4122

## Contact information

- **Practice address:** 238 NW FERRIS DR, PORT ST LUCIE, FL 34983-1121
- **Practice address phone:** (772) 985-4122
- **Practice address fax:** (772) 777-3227
- **Mailing address:** 238 NW FERRIS DR, PORT ST LUCIE, FL 34983-1121
- **Mailing address phone:** (772) 985-4122
- **Mailing address fax:** (772) 777-3227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 6906704 | FL | Yes |

## Other

- **Enumeration date:** 09/10/2014
- **Last updated:** 09/10/2014