Organization
HIBISCUS PALACE WELLINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA WRIGHT MATTIS MSN, RN (ADMINISTRATOR)
(561) 385-2532
Entity
Organization
Contact information
Practice address
1074 HYACINTH PL APT C, WELLINGTON, FL 33414-2144
(561) 333-4179
(561) 909-1548
Mailing address
7181 VIA LEONARDO, LAKE WORTH, FL 33467-5236
(561) 385-2532
(561) 909-1548
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
310400000X
Assisted Living Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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