Organization
EVERLASTING GRACE ASSISTED LIVING INC.
Active
Other names
Care First
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PIER GASMENA (PRESIDENT)
(863) 595-7353
Entity
Organization
Contact information
Practice address
1325 4TH ST N, ST PETERSBURG, FL 33701-1117
(727) 823-6812
(727) 822-2334
Mailing address
747 BON AIR ST, LAKELAND, FL 33805-4631
(863) 688-1196
(863) 687-7707
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL # 5195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142552800
—
FL
Enumeration date
06/09/2008
Last updated
06/09/2008
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