Organization
ENCHANTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLA L DICKENS (OWNER)
(407) 230-3569
Entity
Organization
Contact information
Practice address
6224 BOLLING DR, ORLANDO, FL 32808-6010
(407) 230-3569
Mailing address
6224 BOLLING DR, ORLANDO, FL 32808-6010
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12612
FL
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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