Organization
WHITE FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ETHEL WHITE NURSE (OWNER/ OPERATOR)
(407) 365-9110
Entity
Organization
Contact information
Practice address
4859 PUBLIX ROAD, OVIEDO, FL 32765
(407) 365-9110
(407) 542-7301
Mailing address
4859 PUBLIX ROAD, OVIEDO, FL 32765
(407) 365-9110
(407) 542-7301
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
6905109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141522100
—
FL
Enumeration date
09/04/2012
Last updated
09/04/2012
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