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Organization

THE KING'S PALACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MYRNA PERRIER RN (ADMINISTRATOR)
(407) 272-5141
Entity
Organization

Contact information

Practice address
2291 ALTON RD, DELTONA, FL 32738-4001
(386) 218-5767
(386) 218-3058
Mailing address
2291 ALTON RD, DELTONA, FL 32738-4001
(386) 218-5767
(386) 218-3058

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
372600000X
Adult Companion
385H00000X
Respite Care

Other

Enumeration date
07/17/2013
Last updated
07/17/2013
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