Organization
ASSISTED LOVELY LIVING FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RENITA BUCHANAN (ADMINISTRATOR/OWNER)
(321) 984-8882
Entity
Organization
Contact information
Practice address
1702 TRIMBLE RD, MELBOURNE, FL 32934-9034
(321) 984-8882
Mailing address
2214 MISTY WAY LN, MELBOURNE, FL 32935-1455
(321) 984-8882
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12837
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL12837
ACHA
FL
Enumeration date
07/05/2016
Last updated
07/05/2016
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