Organization
LIFE LONG LEARNING CENTER 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES HOWARD SWIHART (ADMINISTRATOR)
(772) 237-2625
Entity
Organization
Contact information
Practice address
406 SE FALLON DR, PORT SAINT LUCIE, FL 34983-2635
(772) 237-2625
(772) 237-2624
Mailing address
406 SE FALLON DR, PORT SAINT LUCIE, FL 34983-2635
(772) 237-2625
(772) 237-2624
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
AL12123
FL
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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