Organization
FOUR PALMS MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE BERTHELOT (OWNER)
(727) 742-6974
Entity
Organization
Contact information
Practice address
302 11TH AVE NE, ST PETERSBURG, FL 33701-1926
(727) 742-6974
Mailing address
302 11TH AVE NE, ST PETERSBURG, FL 33701-1926
(727) 742-6974
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0016
FL
Other
Enumeration date
05/22/2007
Last updated
07/16/2008
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