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Organization

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Active
Organization subpart
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Provider details

NPI number
Authorized official
MISS WILENE CHARLEMONT PIERRE R.N. (ASSITANT DIRECTOR OF NURSING)
(863) 618-9182
Entity
Organization

Contact information

Practice address
725 CRESTWOOD DR, WINTER HAVEN, FL 33881-2919
(863) 618-9182
Mailing address
725 CRESTWOOD DR, WINTER HAVEN, FL 33881-2919
(863) 618-9182

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
RN9313465
FL

Other

Enumeration date
11/10/2016
Last updated
11/10/2016
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