Organization
BLISS LIFE RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIERGELA DESHOMMES JOSEPH APRN (ADMINISTRATOR)
(239) 603-3734
Entity
Organization
Contact information
Practice address
402 ARTHUR AVE, LEHIGH ACRES, FL 33936-7412
(239) 603-3734
Mailing address
402 ARTHUR AVE, LEHIGH ACRES, FL 33936-7412
(239) 603-3734
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60243
AGENCY FOR HEALTH CARE ADMINISTRATION DIVISION OF HEALTH QUALITY ASSURANCE
FL
Enumeration date
11/02/2020
Last updated
11/02/2020
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