Organization
CRISTAL PALACE RESORT PB, LLC.
Active
Other names
Cristal Palace Resort PB LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEA PHENIX (ADMINISTRATOR)
(321) 951-2989
Entity
Organization
Contact information
Practice address
1881 PALM BAY RD NE, PALM BAY, FL 32905-2978
(321) 951-2989
Mailing address
1881 PALM BAY RD NE, PALM BAY, FL 32905-2978
(321) 951-2989
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12660
FL
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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