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Organization

PORT CHAROLETTE ALF, LLC

Active
Other names
VILLAGE PLACE
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM MANDO (CFO)
(813) 635-9500
Entity
Organization

Contact information

Practice address
18400 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-3343
(941) 766-8224
Mailing address
18400 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-3343
(941) 766-8224

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9249
FL

Other

Enumeration date
06/22/2007
Last updated
06/22/2010
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