Organization
PRIDE TRIBE INC.
Active
Other names
Connie House ALF
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GAYLORD ALLAN HENDRICKS ADMINISTRATOR (CEO)
(561) 541-3700
Entity
Organization
Contact information
Practice address
716 NW 1ST AVE, BOYNTON BEACH, FL 33426-4304
(561) 541-3700
Mailing address
716 NW 1ST AVE, BOYNTON BEACH, FL 33426-4304
(561) 541-3700
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700662376
—
FL
Enumeration date
08/03/2024
Last updated
08/06/2024
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