Organization
BEACHLAND RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMAN GROCHOWSKI (ADMINISTRATOR/OWNER)
(772) 460-8007
Entity
Organization
Contact information
Practice address
462 HERNANDO ST, FORT PIERCE, FL 34949-3243
(772) 460-8007
(772) 460-8007
Mailing address
462 HERNANDO ST, FORT PIERCE, FL 34949-3243
(772) 460-8007
(772) 460-8007
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
8841
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675980700
—
FL
Enumeration date
06/06/2013
Last updated
06/06/2013
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