Organization
FAIRWAY PARK RETIREMENT FACILITY, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE REGNIER (PRESIDENT)
(786) 286-4484
Entity
Organization
Contact information
Practice address
16360 SW 92ND CT, VILLAGE OF PALMETTO BAY, FL 33157-3460
(786) 286-4484
Mailing address
16360 SW 92ND CT, VILLAGE OF PALMETTO BAY, FL 33157-3460
(786) 286-4484
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
10692
FL
310400000X
Assisted Living Facility
Primary
8673
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142405000
—
FL
05
—
142538200
—
FL
Enumeration date
09/24/2008
Last updated
09/24/2008
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