Organization
COLLEEN ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN MARSHALL (OWNER)
(863) 307-1298
Entity
Organization
Contact information
Practice address
5615 ROYAL HILLS ST, WINTER HAVEN, FL 33881-7703
(863) 307-1298
Mailing address
5615 ROYAL HILLS ST, WINTER HAVEN, FL 33881-7703
(863) 307-1298
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
6906156
FL
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143074200
—
FL
Enumeration date
02/17/2017
Last updated
03/06/2019
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