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Organization

BAYSHORE RESIDENCE ALF

Active
Other names
Assisted Living Facility
Organization subpart
No

Provider details

NPI number
Authorized official
MS. VIOLET VERONA BURKE7728711106 (ADMINISTRATOR)
(772) 871-1106
Entity
Organization

Contact information

Practice address
686 SW LUCERO DR, PORT SAINT LUCIE, FL 34983-1894
(772) 871-1106
(772) 871-1104
Mailing address
686 SW LUCERO DR, PORT SAINT LUCIE, FL 34983-1894
(772) 871-1106
(772) 871-1104

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
AL750
FL

Other

Enumeration date
05/08/2008
Last updated
05/08/2008
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