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Organization

ANGEL OF LIGHT ASSISTED LIVING FACILITY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ISOLYN BISHOP (ADMINISTRATOR)
(772) 501-0144
Entity
Organization

Contact information

Practice address
613 SW HOMELAND RD, PORT ST LUCIE, FL 34953-6263
(772) 353-5885
(772) 353-5890
Mailing address
613 SW HOMELAND RD, PORT ST LUCIE, FL 34953-6263
(772) 353-5885

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
09/27/2018
Last updated
09/27/2018
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