Organization
AGNES COTTAGE LLC
Active
Other names
Coquina Cove ALF
Organization subpart
No
Provider details
NPI number
Authorized official
ABIOLA BYRON (ADMINSTRATOR)
(240) 550-2211
Entity
Organization
Contact information
Practice address
3739 SUNRISE OAKS DR, PORT ORANGE, FL 32129-8651
(386) 265-4732
(407) 902-0121
Mailing address
10957 LEDGEMENT LN, WINDERMERE, FL 34786-6423
(240) 550-2211
(407) 902-0121
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
09/20/2021
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