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Organization

POLK COUNTY BOARD OF COUNTY COMMISSIONERS

Active
Other names
CHARLES R. RICHARDSON ADULT DAY CARE CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SAMUEL (SAM) JOHNSON (CHAIRMAN)
(863) 534-6049
Entity
Organization

Contact information

Practice address
615 N JACKSON AVE, BARTOW, FL 33830-3813
(863) 534-0393
Mailing address
2135 MARSHALL EDWARDS DR, BARTOW, FL 33830-6757
(863) 534-5659
(863) 534-5678

Taxonomy

Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
390
FL

Other

Enumeration date
06/18/2008
Last updated
06/18/2008
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