Organization
GREATER VISION FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHEVON STALLWORTH (CEO)
(407) 461-7762
Entity
Organization
Contact information
Practice address
4991 TIMBER RIDGE TRL, OCOEE, FL 34761-8427
(407) 461-7762
(407) 614-2420
Mailing address
PO BOX 918, OCOEE, FL 34761-0918
(407) 461-7762
(407) 614-2420
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
FL
311ZA0620X
Adult Care Home Facility
Primary
—
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
FL
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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