Organization
202 BEVERLY LLC
Active
Other names
Refuge At New Life House
Organization subpart
No
Provider details
NPI number
Authorized official
MILES RAYNOR JR. (CEO)
(678) 255-5990
Entity
Organization
Contact information
Practice address
202 BEVERLY BLVD, BRANDON, FL 33511-5504
(678) 255-5990
Mailing address
202 BEVERLY BLVD, BRANDON, FL 33511-5504
(813) 655-8454
(813) 315-9379
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
07/05/2023
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