Organization
AT HOME OF BREVARD LLC
Active
Other names
Golden Wings Darrow ALF
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH CULLEN (ADMIINISTRATOR)
(321) 676-6331
Entity
Organization
Contact information
Practice address
1351 DARROW RD SW, PALM BAY, FL 32908-6248
(321) 676-6331
(321) 951-2118
Mailing address
1351 DARROW RD SW, PALM BAY, FL 32908-6248
(321) 676-6331
(321) 951-2118
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9150
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
684950400
—
FL
Enumeration date
05/26/2009
Last updated
05/26/2009
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