Organization
GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. L. JUDITH FERMIN-OSTRIN MS, RD (ADMINISTRATOR)
(516) 524-6624
Entity
Organization
Contact information
Practice address
1 PEBBLE WOOD LN, PALM COAST, FL 32164-7491
(386) 447-8145
Mailing address
1 PEBBLE WOOD LN, PALM COAST, FL 32164-7491
(386) 447-8145
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10049
FL
Other
Enumeration date
12/26/2016
Last updated
12/26/2016
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