Organization
A PEACEFUL HOME OF LEWISTON
Active
Other names
A Peaceful Home of Lewiston
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERRY ST JUSTE (PRESIDENT)
(941) 536-6967
Entity
Organization
Contact information
Practice address
22456 LEWISTON AVE, PORT CHARLOTTE, FL 33952-7172
(941) 536-6967
(941) 460-4387
Mailing address
2908 102ND AVE E, PARRISH, FL 34219-9203
(941) 536-6967
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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