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Organization

SOUTHERN LIVING OF TITUSVILLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LISA WARING (OWNER/ADMINISTRATOR)
(321) 225-4668
Entity
Organization

Contact information

Practice address
2375 E JAY JAY RD, TITUSVILLE, FL 32796-1316
(321) 225-4668
(321) 225-4668
Mailing address
2375 E JAY JAY RD, TITUSVILLE, FL 32796-1316
(321) 225-4668
(321) 225-4668

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12517
FL

Other

Enumeration date
01/04/2017
Last updated
01/04/2017
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