Organization
EASTON'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDIANA HEIN (ADMINISTRATOR)
(850) 603-5917
Entity
Organization
Contact information
Practice address
2301 W JAMES LEE BLVD, CRESTVIEW, FL 32536-5409
(850) 306-2618
Mailing address
2301 W JAMES LEE BLVD, CRESTVIEW, FL 32536-5409
(850) 306-2618
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12975
FL
385H00000X
Respite Care
AL12975
FL
Other
Enumeration date
03/22/2017
Last updated
04/15/2017
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