Organization
KIST ALF, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON KIST (OWNER)
(386) 566-1020
Entity
Organization
Contact information
Practice address
1516 CARMEN AVENUE, DAYTONA BEACH, FL 32117
(386) 239-9774
Mailing address
1516 CARMEN AVENUE, DAYTONA BEACH, FL 32117
(386) 239-9774
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9802
FL
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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