Organization
AT HOME CARE ASSISTED LIVING FACILITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEISHA LATOYA GIST (ADMINISTRATOR)
(407) 948-0723
Entity
Organization
Contact information
Practice address
42042 CHINABERRY ST, EUSTIS, FL 32736-8358
(407) 948-0723
(321) 256-5193
Mailing address
42042 CHINABERRY ST, EUSTIS, FL 32736-8358
(407) 948-0723
(321) 256-5193
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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