Organization
BOSWELL MANOR LLC
Active
Other names
Boswell Manor LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LACEY BOSWELL (OWNER/ADMINISTRATOR)
(850) 768-9026
Entity
Organization
Contact information
Practice address
2185 HIGHWAY 173, BONIFAY, FL 32425-5705
(850) 768-9026
Mailing address
2185 HIGHWAY 173, BONIFAY, FL 32425-5705
(850) 768-9026
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100834700
—
FL
Enumeration date
12/17/2018
Last updated
12/17/2018
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