Organization
FAVOR MEMORYCARE ASSISTED LIVING FACILITY INC
Active
Other names
Favor Memorycare assisted living facility inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER ETOH (OWNER/ADMINISTRATOR)
(407) 415-5064
Entity
Organization
Contact information
Practice address
385 E WILDMERE AVE, LONGWOOD, FL 32750-5537
(407) 951-6926
Mailing address
385 E WILDMERE AVE, LONGWOOD, FL 32750-5537
(407) 951-6926
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13066
FL
310400000X
Assisted Living Facility
13066
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720418635
—
FL
Enumeration date
10/10/2017
Last updated
06/16/2018
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