Organization
GLENN'S FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KETTELIE GLENN ADMINSTRATOR (ADMINISTRATOR)
(561) 574-6460
Entity
Organization
Contact information
Practice address
6953 MITCHELL ST, JUPITER, FL 33458-3852
(561) 574-6460
(561) 328-6015
Mailing address
6953 MITCHELL ST, JUPITER, FL 33458-3852
(561) 574-6460
(561) 328-6015
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906689
FL
Other
Enumeration date
06/23/2014
Last updated
09/23/2014
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