Organization
CASUAL COUNTRY LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY LEE DUNLEAVY CORE TRANING (OWNER ADMINISTRATOR)
(321) 632-9622
Entity
Organization
Contact information
Practice address
4801 MANGO AVE, COCOA, FL 32926-2921
(321) 632-9622
(321) 632-9622
Mailing address
4801 MANGO AVE, COCOA, FL 32926-2921
(321) 632-9622
(321) 632-9622
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10167
FL
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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