Organization
LIVING WELL ADULT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOUNA MATIEU RN (CO-DIRECTOR)
(813) 240-6199
Entity
Organization
Contact information
Practice address
2911 WHEELER ST, BARTOW, FL 33830-9316
(813) 240-6199
Mailing address
611 POINSETTIA RD, AUBURNDALE, FL 33823-4520
(863) 595-5845
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
RN9416352
FL
311ZA0620X
Adult Care Home Facility
Primary
RN9462914
FL
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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