Organization
THE GATHERING PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH MARIE MCKINSEY (CO-OWNER)
(941) 623-6878
Entity
Organization
Contact information
Practice address
3459 DEPEW AVE, PORT CHARLOTTE, FL 33952
(941) 623-6878
Mailing address
PO BOX 494242, PORT CHARLOTTE, FL 33949-4242
(941) 623-6878
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN1358061
FL
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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