Organization
MOTHERLYCARE ASSISTED LIVING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA HIDALGO VICENCIO RN (OWNER/ ADMINISTRATOR)
(386) 742-1148
Entity
Organization
Contact information
Practice address
5 BIG DIPPER LN, PALM COAST, FL 32137-9355
(386) 742-1148
(386) 742-1151
Mailing address
12 CEDARWOOD CT, PALM COAST, FL 32137-8947
(386) 742-1148
(386) 742-1151
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12779
FL
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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