Organization
PRIME IS CARE
Active
Organization
PRIME IS CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLON PRIMOUS (PRESIDENT)
(772) 924-9006
Entity
Organization
Contact information
Practice address
2621 SW HAREM CIR, PORT ST LUCIE, FL 34953-2953
(772) 924-9006
Mailing address
2621 SW HAREM CIR, PORT ST LUCIE, FL 34953-2953
(772) 924-9006
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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