Organization
EDITH KELLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH KELLER (OWNER)
(727) 375-8063
Entity
Organization
Contact information
Practice address
5018 YELLOWSTONE DR, NEW PORT RICHEY, FL 34655-4380
(727) 375-8063
Mailing address
5018 YELLOWSTONE DR, NEW PORT RICHEY, FL 34655-4380
(727) 375-8063
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905561
FL
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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