Organization
PARADISE PORT ST LUCIE, LLC
Active
Other names
Paradise Care Cottage
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA ROSE BASS (ADMINISTRATOR)
(772) 398-8899
Entity
Organization
Contact information
Practice address
2277 SE LENNARD RD, PORT ST LUCIE, FL 34952-6889
(772) 398-8899
(772) 398-3322
Mailing address
2277 SE LENNARD RD, PORT ST LUCIE, FL 34952-6889
(772) 398-8899
(772) 398-3322
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8585
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
679064000
—
FL
Enumeration date
05/13/2008
Last updated
05/13/2008
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