Organization
MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN NORTHOVER NHA (ADMINISTRATOR)
(407) 644-6634
Entity
Organization
Contact information
Practice address
550 W MORSE BLVD, WINTER PARK, FL 32789-4206
(407) 644-6634
(407) 645-2520
Mailing address
550 W MORSE BLVD, WINTER PARK, FL 32789-4206
(407) 644-6634
(407) 645-2520
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1324096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020158800
—
FL
Enumeration date
03/21/2007
Last updated
11/18/2010
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