Organization
HOUSE OF LIGHT SENIOR LIVING III
Active
Parent organization
HOUSE OF LIGHT SENIOR LIVING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOUSE OF LIGHT SENIOR LIVING, LLC
Authorized official
MS. VIVIENE CORNETTA MOORE (ADMINISTRATOR)
(321) 368-5611
Entity
Organization
Contact information
Practice address
2306 WOODLAWN CIR, MELBOURNE, FL 32934-7645
(321) 368-5611
(321) 345-5925
Mailing address
2306 WOODLAWN CIR, MELBOURNE, FL 32934-7645
(321) 368-5611
(321) 345-5925
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
Other
Enumeration date
10/04/2014
Last updated
10/04/2014
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