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Organization

DELTONA ALF MANAGEMENT

Active
Other names
Gold Choice Deltona
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DERICK WAYNE DEETER (MANAGER)
(407) 202-0046
Entity
Organization

Contact information

Practice address
2306 N NORMANDY BLVD, DELTONA, FL 32725
(386) 259-3860
(386) 259-3872
Mailing address
2306 N. NORMANDY BLVD, DELTONA, FL 32725
(386) 259-3860
(386) 259-3872

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL13087
FL
310400000X
Assisted Living Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022682200
FL
Enumeration date
11/16/2016
Last updated
12/20/2017
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