Organization
TORO12 LLC
Active
Other names
homestead retirement home
Organization subpart
No
Provider details
NPI number
Authorized official
JACEK DYGDON (OWNER)
(386) 315-0899
Entity
Organization
Contact information
Practice address
1117 MASSACHUSETTS AVE, SAINT CLOUD, FL 34769-3787
(407) 593-6521
Mailing address
1117 MASSACHUSETTS AVE, SAINT CLOUD, FL 34769-3787
(407) 593-6521
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AL245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010471600
—
FL
Enumeration date
06/11/2014
Last updated
06/11/2014
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