Organization
HAILES BOARDING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANNE R WILSON (ADMINISTRATOR)
(813) 251-1327
Entity
Organization
Contact information
Practice address
1009 N. WILLOW AVE., TAMPA, FL 33607
(813) 251-1327
Mailing address
1009 N WILLOW AVE, TAMPA, FL 33607-5549
(813) 251-1327
(813) 259-9928
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9732
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140354100
—
FL
Enumeration date
10/07/2008
Last updated
10/07/2008
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