Organization
ALTERNATIVE LIVING, INC.
Active
Other names
Crestview Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH R. LOVEJOY (ADMINISTRATOR)
(850) 833-9165
Entity
Organization
Contact information
Practice address
603 NORTH PEARL STREET, CRESTVIEW, FL 32536
(850) 689-7850
(850) 689-7974
Mailing address
207 HOSPITAL DRIVE, FORT WALTON BEACH, FL 32548
(850) 833-9165
(850) 833-9174
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5649
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676877600
—
FL
Enumeration date
08/02/2011
Last updated
08/02/2011
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