Organization
ALTERNATIVE LIVING INC.
Active
Other names
Crestview Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY ANN FRALEY (ASSISTANT ADMINISTRATOR)
(850) 833-9212
Entity
Organization
Contact information
Practice address
603 N PEARL ST, CRESTVIEW, FL 32536-2749
(850) 689-7850
(850) 689-7974
Mailing address
207 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5066
(850) 833-9165
(850) 833-9165
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5649
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676877600
—
FL
Enumeration date
11/18/2011
Last updated
11/18/2011
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