Organization
ROSEWELL HOME AND RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ICYLIN DOUGLAS (ADMINISTRATOR)
(772) 777-4463
Entity
Organization
Contact information
Practice address
3366 SW VENDOME ST, PORT SAINT LUCIE, FL 34953-3407
(772) 777-4463
(772) 673-6203
Mailing address
3366 SW VENDOME ST, PORT SAINT LUCIE, FL 34953-3407
(772) 777-4463
(772) 673-6203
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12708
FL
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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