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Organization
SWAN S.P. ENTERPRISES
Active
Organization
SWAN S.P. ENTERPRISES
Active
Parent organization
SWAN S P ENTERPRISES
Other names
PROMISE MANOR WELLCARe
Organization subpart
Yes
Provider details
NPI number
Legal business name
SWAN S P ENTERPRISES
Authorized official
SANDRA M CAMERON (ADMINISTRATOR)
(561) 863-7481
Entity
Organization
Contact information
Practice address
45 W 17TH ST, RIVIERA BEACH, FL 33404-6121
(561) 863-7481
Mailing address
45 W 17TH ST, RIVIERA BEACH, FL 33404-6121
(561) 863-7481
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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