Organization
KIP & ASSOCIATES
Active
Other names
The View at Casselberry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PEDRO PORTUONDO MA (CEO)
(321) 279-5197
Entity
Organization
Contact information
Practice address
369 FAIRGREEN PL, CASSELBERRY, FL 32707-5205
(321) 279-5197
Mailing address
369 FAIRGREEN PLACE, CASSELBERRY, FL 32707
(321) 279-5197
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
AL12344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL12344
AGENCY FOR HEALTH CARE ADMINISTRATION
FL
Enumeration date
05/01/2013
Last updated
05/01/2013
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