Organization
CMFMC INC
Active
Other names
Azalea Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PROSERFINO PATACSIL (ADMINISTRATOR)
(407) 282-0556
Entity
Organization
Contact information
Practice address
150 WILLOW DR, ORLANDO, FL 32807-3222
(407) 282-0556
(407) 282-2231
Mailing address
150 WILLOW DR, ORLANDO, FL 32807-3222
(407) 282-0556
(407) 282-2231
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL4839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691349100
—
FL
Enumeration date
05/20/2008
Last updated
05/20/2008
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