Organization
LISE'S GARDEN AFCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISE I HYPPOLITE-ALPHONSE (ADMINISTRATOR)
(321) 948-8533
Entity
Organization
Contact information
Practice address
1542 PROVIDENCE CIR, ORLANDO, FL 32818-5708
(407) 668-4654
Mailing address
1542 PROVIDENCE CIR, ORLANDO, FL 32818-5708
(407) 668-4654
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906849
FL
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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