Organization
ST. MARY'S HOME ASSISTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES LAYUGAN BATTUNG (ADMINISTRATOR)
(407) 843-0951
Entity
Organization
Contact information
Practice address
718 W WINTER PARK ST, ORLANDO, FL 32804-4902
(407) 843-0951
Mailing address
718 W WINTER PARK ST, ORLANDO, FL 32804-4902
(407) 843-0951
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL4860
FL
Other
Enumeration date
12/17/2014
Last updated
12/18/2014
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