Organization
FAMILY EXTENDED CARE OF PUNTA GORDA, INC
Active
Other names
Vick Street Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA M LEWIS (DIRECTOR OF QUALITY ASSURANCE)
(239) 247-3248
Entity
Organization
Contact information
Practice address
22332 VICK ST, PORT CHARLOTTE, FL 33980-2053
(941) 627-5388
(941) 627-2007
Mailing address
22332 VICK ST, PORT CHARLOTTE, FL 33980-2053
(941) 627-5388
(941) 627-2007
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5016
FL
Other
Enumeration date
12/24/2010
Last updated
12/24/2010
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