Organization
PHYLLIS BAIRD ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLUS BAIRD (OWNER)
(941) 743-0778
Entity
Organization
Contact information
Practice address
284 COMSTOCK ST, PORT CHARLOTTE, FL 33954-3627
(941) 743-0778
Mailing address
284 COMSTOCK ST, PORT CHARLOTTE, FL 33954-3627
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
3
FL
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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