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Organization

HOUSE OF LIGHT SENIOR LIVING, LLC

Active
Parent organization
HOUSE OF LIGHT SENIOR LIVING, LLC
Other names
House of Light Senior Living II
Organization subpart
Yes

Provider details

NPI number
Legal business name
HOUSE OF LIGHT SENIOR LIVING, LLC
Authorized official
MS. VIVIENE CORNETTA MOORE (ADMINISTRATOR)
(321) 806-7091
Entity
Organization

Contact information

Practice address
1797 BLAINE ST NE, PALM BAY, FL 32905-5142
(321) 914-3658
(321) 345-5925
Mailing address
1797 BLAINE ST NE, PALM BAY, FL 32905-5142
(321) 914-3658
(321) 345-5925

Taxonomy

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

Other

Enumeration date
02/04/2014
Last updated
11/23/2022
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