Organization
SHALIMARE INC.
Active
Other names
Shalimare Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ELLEN PROVENCHER (PRESIDENT OF SHALIMARE INC.)
(239) 839-4997
Entity
Organization
Contact information
Practice address
613 CAROLINA AVE, FORT MYERS, FL 33905-4015
(239) 839-4997
(239) 693-1121
Mailing address
613 CAROLINA AVE, FORT MYERS, FL 33905-4015
(239) 839-4997
(239) 693-1121
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
06/27/2007
Last updated
08/22/2020
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