Organization
GREEN ACRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ T KALBARCZYK (OWNER/ADMINSTRATOR)
(727) 861-2975
Entity
Organization
Contact information
Practice address
15820 ARCHER ST, HUDSON, FL 34667-3816
(727) 861-2975
(727) 857-4533
Mailing address
15820 ARCHER ST, HUDSON, FL 34667-3816
(727) 861-2975
(727) 857-4533
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
AI8642
FL
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AI8642
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140906900
—
FL
Enumeration date
07/16/2014
Last updated
01/20/2017
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