Organization
NELISHA FAMILY HOME LLC
Active
Other names
Assisted Living Facililty
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA W. BROWN REGISTERED NURSE (ADMINISTRATOR)
(772) 340-4671
Entity
Organization
Contact information
Practice address
3871 SW RAMSPECK ST, PORT ST LUCIE, FL 34953
(772) 340-4671
(772) 264-0592
Mailing address
3871 SW RAMSPECK ST, PORT ST LUCIE, FL 34953
(772) 340-4671
(772) 264-0592
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
12437
FL
310400000X
Assisted Living Facility
12692
FL
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FL024319000
—
FL
Enumeration date
04/29/2013
Last updated
12/14/2018
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