Organization
BLUE FOUNTAIN HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDAD DELINOIS (ADMINISTRATOR/OWNER)
(954) 559-3265
Entity
Organization
Contact information
Practice address
2440 EMERSON DR SE, PALM BAY, FL 32909-4972
(321) 327-8762
(321) 914-4069
Mailing address
2440 EMERSON DR SE, PALM BAY, FL 32909-4972
(321) 327-8762
(321) 914-4069
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11411
FL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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