Organization
PANSY'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEMIA TIERRE PRINCE (OWNER/ADMINISTRATOR)
(561) 287-0308
Entity
Organization
Contact information
Practice address
2058 PINEHURST DR, WEST PALM BEACH, FL 33407-3546
(561) 287-0305
(561) 247-7627
Mailing address
1905 W BLUE HERON BLVD, RIVIERA BEACH, FL 33404-5149
(561) 287-0305
(567) 247-7627
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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