Organization
GLENVILLE PINES II ASSISTED LIVING FACILITY LLC
Active
Other names
GLENVILLE PINES II ASSISTED LIVING FACILITY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIDA M REYES-KERR (ADMINISTRATOR)
(321) 258-4056
Entity
Organization
Contact information
Practice address
211 SILVER OAK RD NE, PALM BAY, FL 32907-5582
(321) 802-4121
(321) 984-7568
Mailing address
1351 STEELE RD SE, PALM BAY, FL 32909-5332
(321) 258-4056
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022322700
—
FL
Enumeration date
04/05/2018
Last updated
04/05/2018
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