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Organization

GINNY'S PLACE OF VIERA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE A.C. DURGIN LCSW (ADMINISTRATOR / OWNER)
(321) 258-2351
Entity
Organization

Contact information

Practice address
1198 AUBURN LAKES DR, ROCKLEDGE, FL 32955-6780
(321) 258-2351
Mailing address
685 ROSSMOOR CIR, MELBOURNE, FL 32940-1963
(321) 258-2351

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11161
FL

Other

Enumeration date
04/18/2012
Last updated
04/18/2012
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