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Organization

EVELYN'S HOME ASSISTED LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FLORENCE WOBERAERE EJIOWHOR RN (OWNER/ADMINISTRATOR)
(407) 497-1243
Entity
Organization

Contact information

Practice address
2119 BEACON LANDING CIR, ORLANDO, FL 32824-4374
(407) 497-1243
(407) 888-9121
Mailing address
2119 BEACON LANDING CIR, ORLANDO, FL 32824-4374
(407) 497-1243
(407) 888-9121

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL13064
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022295400
FL
01
1396255139
NPI
Enumeration date
04/18/2018
Last updated
06/16/2018
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