Organization
LORRAINE ASSISTED CARE DBA MELISSA ANN BONGART
Active
Other names
Melissa Ann Bongart
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN BONGART (OWNER)
(941) 504-9412
Entity
Organization
Contact information
Practice address
5916 LORRAINE RD, BRADENTON, FL 34211-9208
(941) 504-9412
Mailing address
5916 LORRAINE ROAD, BRADENTON, FL 34211
(941) 504-9412
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906389
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004043700
—
FL
Enumeration date
03/15/2013
Last updated
03/15/2013
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