Organization
ANGELS LANDING OF BREVARD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN MARTINEZ (OWNER/ADMINISTRATOR)
(321) 473-8692
Entity
Organization
Contact information
Practice address
731 NW ALTONA STREET, PALM BAY, FL 32907
(321) 473-8692
(321) 473-8692
Mailing address
731 NW ALTONA STREET, PALM BAY, FL 32907
(321) 473-8692
(321) 473-8692
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
10932
FL
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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