Organization
PRIVATE LIFE RETIREMENT PLACE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIANE DERONVIL (OWNER)
(954) 588-1941
Entity
Organization
Contact information
Practice address
1451 NE 30TH ST, POMPANO BEACH, FL 33064-6834
(954) 588-1941
Mailing address
1451 NE 30TH ST, POMPANO BEACH, FL 33064-6834
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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