Organization
1ST LIGHT OF HOPE
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON DURANTE ANDREWS (OWNER)
(772) 214-5860
Entity
Organization
Contact information
Practice address
118 SW ANDOVER CT, PORT SAINT LUCIE, FL 34953-6961
(772) 214-5860
(800) 854-2598
Mailing address
4451 SW DARLINGTON ST, PORT SAINT LUCIE, FL 34953-7607
(772) 214-5860
(800) 854-2598
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1262
—
FL
Enumeration date
02/28/2021
Last updated
02/28/2021
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