Organization
ELIDA M. REYES-KERR
Active
Other names
Glenville Pines ALF
Organization subpart
No
Provider details
NPI number
Authorized official
ELIDA M REYES-KERR (OWNER)
(321) 984-7568
Entity
Organization
Contact information
Practice address
1351 STEELE RD SE, PALM BAY, FL 32909-5332
(321) 989-7568
Mailing address
1351 STEELE RD SE, PALM BAY, FL 32909-5332
(321) 989-7568
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12126
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005613700
—
FL
Enumeration date
06/19/2013
Last updated
06/19/2013
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