Organization
PELICAN HAVEN,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE JULMEUS (DIRECTOR/OWNER)
(239) 872-0718
Entity
Organization
Contact information
Practice address
4310 14TH ST SW, LEHIGH ACRES, FL 33976-2731
(239) 674-7051
Mailing address
4310 14TH ST SW, LEHIGH ACRES, FL 33976-2731
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
001926400
FL
251G00000X
Community Based Hospice Care Agency
Primary
089390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001302600
—
FL
05
—
001925800
—
FL
05
—
001926400
—
FL
Enumeration date
09/13/2010
Last updated
09/13/2010
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