Organization
FAIRWAY CHALET, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANILO LABIOS (PRESIDENT)
(727) 934-4970
Entity
Organization
Contact information
Practice address
905 VIRGINIA AVE, TARPON SPRINGS, FL 34689-2677
(727) 934-4970
Mailing address
905 VIRGINIA AVE, TARPON SPRINGS, FL 34689-2677
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009186900
—
FL
Enumeration date
12/12/2008
Last updated
07/25/2019
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