Organization
AMAZING GRACE ASSISTED LIVING HOME III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE LYTLE (OWNER)
(561) 818-5790
Entity
Organization
Contact information
Practice address
1851 EVERGREEN DR, LAKE CLARKE SHORES, FL 33406-5231
(561) 642-4221
Mailing address
1851 EVERGREEN DR, LAKE CLARKE SHORES, FL 33406-5231
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12836
FL
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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