Organization
POLK COUNTY BOARD OF COUNTY COMMISSIONERS
Active
Other names
ADULT DAY CARE CENTERS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL (SAM) JOHNSON (CHAIRMAN)
(863) 534-6049
Entity
Organization
Contact information
Practice address
2135 MARSHALL EDWARDS DR, BARTOW, FL 33830-6757
(863) 534-5229
Mailing address
2135 MARSHALL EDWARDS DR, BARTOW, FL 33830-6757
(863) 534-5229
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13157
UNIVERSAL HEALTH CARE COMMUNITY DIVERSION PROGRAM
FL
01
—
60-01544
EVERCARE HEALTH & HOME CONNECTION
FL
Enumeration date
05/28/2008
Last updated
05/28/2008
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