Organization
PROFESSIONAL CARE COORDINATORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANAELLE DESRIVIERES (ADMINISTRATOR)
(561) 506-0970
Entity
Organization
Contact information
Practice address
13953 EXOTICA LN, WELLINGTON, FL 33414-8182
(561) 506-0970
Mailing address
13953 EXOTICA LN, WELLINGTON, FL 33414-8182
(561) 506-0970
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
234662
FL
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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