Organization
OAK VALLEY ALF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONROE FRANK EASTERLING II (OWNER)
(850) 535-4196
Entity
Organization
Contact information
Practice address
4488 HIGHWAY 79, VERNON, FL 32462-3778
(850) 535-4196
(850) 535-0271
Mailing address
4488 HIGHWAY 79, VERNON, FL 32462-3778
(850) 535-4196
(850) 535-0271
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL11647
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001563700
—
FL
Enumeration date
03/16/2011
Last updated
03/16/2011
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