Organization
STAR ANGELS ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA FRANKLIN WEIR CNA (ADMINISTRATOR)
(772) 233-2331
Entity
Organization
Contact information
Practice address
415 - SW SADWICK AVE., PORT SAINT LUCIE, FL 34953
(772) 233-2331
Mailing address
415 SW SADWICK AVE, PORT SAINT LUCIE, FL 34953
(772) 233-2331
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
6906565
FL
311Z00000X
Custodial Care Facility
6906565
FL
314000000X
Skilled Nursing Facility
6906565
FL
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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