Organization
FOR HIS GLORY ALF LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEZIAH SWABY (ADMINISTRATOR)
(305) 952-0745
Entity
Organization
Contact information
Practice address
322 SW SOUTH QUICK CIRCLE, PORT ST LUCIE, FL 34953
(772) 785-5785
(772) 785-5790
Mailing address
1899 SW NEWPORT ISLES BLVD, PORT ST LUCIE, FL 34953-4380
(305) 952-0745
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL13204
FL
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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